妊娠中期双顶径大小与不良妊娠结局的风险。

Second trimester biparietal diameter size and the risk of adverse pregnancy outcomes.

机构信息

Perinatology Division, Obstetrics and Gynecology Department, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Prenat Diagn. 2011 Oct;31(10):995-8. doi: 10.1002/pd.2823. Epub 2011 Jul 11.

DOI:10.1002/pd.2823

PMID:21744368

Abstract

OBJECTIVE

To identify the relationship between biparietal diameter (BPD) in the second trimester and adverse pregnancy outcomes in low-risk pregnancies.

METHOD

This prospective cohort study was performed on 2219 singleton pregnant women from August 2008 to March 2010. The gestational age-specific percentiles of BPD at 17 to 24 weeks of gestation were established to categorize participants into three groups: a BPD < 10th percentile as small BPD, between 10th and 90th percentile as normal BPD and > 90th percentile as large BPD. Using logistic regression analysis, the association between BPD < 10th and > 90th percentile with pregnancy outcomes was evaluated after controlling for confounding factors.

RESULTS

There was a significantly increased risk of macrosomia [odds ratio (OR(adj)) = 2.1; 95% confidence intervals (CI), 1.23-3.78] and preterm labor (PTL) (OR(adj) = 1.9; 95% CI, 1.19-3.05) in fetuses with a BPD > 90th percentile compared with fetuses with a normal BPD, and there was a significant relationship between small for gestational age (SGA) at delivery and a BPD < 10th percentile at the second trimester (OR(adj) = 2.4; 95% CI, 1.77-3.52). No association was present between preeclampsia and second trimester BPD.

CONCLUSION

BPD in the first half of pregnancy is related to fetal size at term and risk of PTL.

摘要

目的

确定孕中期双顶径（BPD）与低危妊娠不良妊娠结局之间的关系。

方法

本前瞻性队列研究于 2008 年 8 月至 2010 年 3 月对 2219 例单胎孕妇进行，建立了 17-24 孕周特异性双顶径百分位数，将参与者分为三组：BPD<第 10 百分位数为小 BPD，第 10-90 百分位数为正常 BPD，>第 90 百分位数为大 BPD。采用 logistic 回归分析，在校正混杂因素后，评估 BPD<第 10 百分位和>第 90 百分位与妊娠结局的关系。

结果

与正常 BPD 胎儿相比，BPD>第 90 百分位胎儿发生巨大儿的风险显著增加[比值比（OR（adj））=2.1；95%置信区间（CI），1.23-3.78]和早产（PTL）（OR（adj）=1.9；95%CI，1.19-3.05），而与孕中期 BPD<第 10 百分位相比，分娩时胎儿生长受限（SGA）与孕中期 BPD<第 10 百分位显著相关（OR（adj）=2.4；95%CI，1.77-3.52）。未发现子痫前期与孕中期 BPD 之间存在关联。