Hasegawa Junichi, Arakawa Kaori, Nakamura Masamitsu, Matsuoka Ryu, Ichizuka Kiyotake, Katsufumi Otsuki, Sekizawa Akihiko, Okai Takashi
Department of Obstetrics and Gynecology, Showa University School of Medicine, Tokyo, Japan.
J Obstet Gynaecol Res. 2011 Nov;37(11):1658-65. doi: 10.1111/j.1447-0756.2011.01600.x. Epub 2011 Jul 27.
To establish a nomogram of placental weight at delivery and to clarify the associations among standardized placental weights and known risk factors of fetal growth restriction (FGR).
Consequent cases who delivered singleton babies after 22 weeks of gestation at our hospital between 2005 and 2009 were retrospectively analyzed using the hospital database. The data of neonatal birth weight, placental weight, maternal demographics and variables associated with FGR were collected. From these data, we established the nomogram of neonatal and placental weight, and fetal:placental weight ratio against gestational age at the delivery. According to regression formula, the z-score of the neonatal and placental weights were calculated, and the relation between the standardized placental weights and risk factors associated with growth restriction were analyzed.
Nomograms of neonatal and placental weight, and fetal:placental weight ratio were demonstrated using 3434 cases. Z-scores of placental weights were low in cases with low maternal body mass index, preeclampsia, abnormal placental forms and short umbilical cord. They were also low in cases with 'placental dysfunction', which we usually defined when any other known risk factor was not seen in FGR cases.
A standard curve of placental weight would be a useful tool to explain a certain degree of placental development and the cause of FGR, and to use for further research.
建立分娩时胎盘重量的列线图，并阐明标准化胎盘重量与胎儿生长受限（FGR）已知风险因素之间的关联。
利用我院医院数据库对2005年至2009年间妊娠22周后分娩单胎婴儿的连续病例进行回顾性分析。收集新生儿出生体重、胎盘重量、母亲人口统计学资料以及与FGR相关的变量。从这些数据中，我们建立了新生儿和胎盘重量以及胎儿与胎盘重量比相对于分娩时孕周的列线图。根据回归公式计算新生儿和胎盘重量的z评分，并分析标准化胎盘重量与生长受限相关风险因素之间的关系。
使用3434例病例展示了新生儿和胎盘重量以及胎儿与胎盘重量比的列线图。母亲体重指数低、子痫前期、胎盘形态异常和脐带短的病例中胎盘重量的z评分较低。在“胎盘功能障碍”的病例中z评分也较低，我们通常在FGR病例中未发现任何其他已知风险因素时定义为“胎盘功能障碍”。
胎盘重量的标准曲线将是解释一定程度胎盘发育和FGR原因以及用于进一步研究的有用工具。
