人群胎儿生长标准与产时队列中不良结局的关系。
Population versus customized fetal growth norms and adverse outcomes in an intrapartum cohort.
机构信息
Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas, USA.
出版信息
Am J Perinatol. 2013 Apr;30(4):335-41. doi: 10.1055/s-0032-1324708. Epub 2012 Aug 14.
OBJECTIVE
To compare population versus customized fetal growth norms in identifying neonates at risk for adverse outcomes (APO) associated with small for gestational age (SGA).
STUDY DESIGN
Secondary analysis of an intrapartum fetal pulse oximetry trial in nulliparous women at term. Birth weight percentiles were calculated using ethnicity- and gender-specific population norms and customized norms (Gardosi).
RESULTS
Of the studied neonates, 508 (9.9%) and 584 (11.3%) were SGA by population (SGApop) and customized (SGAcust) norms, respectively. SGApop infants were significantly associated with a composite adverse neonatal outcome, neonatal intensive care admission, low fetal oxygen saturation, and reduced risk of cesarean delivery; both SGApop and SGAcust infants were associated with a 5-minute Apgar score < 4. The ability of customized and population birth weight percentiles in predicting APO was poor (12 of 14 APOs had area under the curve of <0.6).
CONCLUSION
In this intrapartum cohort, neither customized nor normalized population norms adequately identified neonates at risk of APO related to SGA.
目的
比较人群与定制胎儿生长标准在识别与胎龄小相关的不良结局（APO）风险的新生儿中的作用。
研究设计
对足月初产妇胎儿脉搏血氧饱和度试验的二次分析。使用种族和性别特定的人群标准和定制标准（Gardosi）计算出生体重百分位数。
结果
在所研究的新生儿中，分别有 508 名（9.9%）和 584 名（11.3%）按照人群（SGApop）和定制（SGAcust）标准为 SGA。SGApop 婴儿与复合不良新生儿结局、新生儿重症监护入院、低胎儿氧饱和度以及剖宫产风险降低显著相关；SGApop 和 SGAcust 婴儿均与 5 分钟 Apgar 评分<4 相关。定制和人群出生体重百分位数预测 APO 的能力较差（14 个 APO 中有 12 个曲线下面积<0.6）。
结论
在这个分娩队列中，定制和标准化的人群标准都不能充分识别与 SGA 相关的 APO 风险的新生儿。
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