Özlü Tülay, Ozcan Tulin
Department of Obstetrics and Gynecology, University of Rochester, Rochester, NY, USA; Abant İzzet Baysal Üniversitesi, T𝚤p Fakültesi, Kad𝚤n Hastal𝚤klar𝚤 ve Doğum AD, Bolu, Türkiye.
Prenat Diagn. 2013 Nov;33(11):1063-9. doi: 10.1002/pd.4197. Epub 2013 Aug 4.
This study aims to evaluate the association of isolated short femur (ISF) in the second trimester ultrasound with adverse pregnancy outcomes.
All obstetric scans between 16 and 24 weeks of gestation from 1 January 2006 to 1 June 2012 were retrospectively evaluated. Multiple pregnancies, major congenital or chromosomal anomalies and subjects with incomplete outcome data were excluded. Femur length (FL) measurement from the earliest scan of singleton pregnancies was selected. An ISF was defined as a FL less than the tenth percentile in a fetus with an abdominal circumference greater than or equal to the tenth percentile. The primary outcomes were small for gestational age (SGA), birth weight below the third and fifth percentiles, low birth weight (LBW), preterm birth (PTB) and preeclampsia (PE). A 5-min Apgar score of less than 7 and a neonatal intensive care unit admission were secondary outcomes.
Of the 4992 eligible fetuses, 312 (6%) had an ISF. Mothers in the short femur group were shorter and had a lower prepregnancy and delivery weight than the group with normal FL (p < 0.05). Multiple logistic regression revealed a significant increase in birth weight below fifth percentile, SGA, LBW infants and PTB (<32, <34 and <37 weeks) in the ISF group (p < 0.05). The incidence of PE was similar in both groups.
Isolated short femur in the second trimester increases the risk of LBW, SGA and PTB, but not of PE.
本研究旨在评估孕中期超声检查中孤立性短股骨（ISF）与不良妊娠结局之间的关联。
回顾性评估2006年1月1日至2012年6月1日期间妊娠16至24周的所有产科超声检查。排除多胎妊娠、重大先天性或染色体异常以及结局数据不完整的受试者。选择单胎妊娠最早一次扫描时的股骨长度（FL）测量值。ISF定义为腹围大于或等于第10百分位数的胎儿中FL小于第10百分位数。主要结局为小于胎龄儿（SGA）、出生体重低于第3和第5百分位数、低出生体重（LBW）、早产（PTB）和先兆子痫（PE）。5分钟Apgar评分小于7分和新生儿重症监护病房入院为次要结局。
在4992例符合条件的胎儿中，312例（6%）有ISF。短股骨组母亲比股骨长度正常组母亲身材更矮，孕前体重和分娩体重更低（p<0.05）。多因素逻辑回归显示，ISF组出生体重低于第5百分位数、SGA、LBW婴儿和PTB（<32周、<34周和<37周）的发生率显著增加（p<0.05）。两组PE的发生率相似。
孕中期孤立性短股骨会增加LBW、SGA和PTB的风险，但不会增加PE的风险。
