Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia.
J R Soc Interface. 2013 Aug 21;10(88):20130376. doi: 10.1098/rsif.2013.0376. Print 2013 Nov 6.
The relationship between Doppler measurements, size and growth rate in fetal growth restriction has not been defined. We used functional linear discriminant analysis (FLDA) to investigate these parameters taking account of the difficulties inherent in exploring relationships between repeated observations from a small number of cases. In 40 fetuses with severe growth restriction, serial abdominal circumference (AC), umbilical, middle cerebral artery (MCA) and ductus venosus Doppler pulsatility index measurements were recorded. In 11 singleton fetuses with normal growth, umbilical artery pulsatility index only was measured. Data were expressed as z-scores in relation to gestation and analysed longitudinally using FLDA. In severe growth restriction, the Spearman correlation coefficients between umbilical artery pulsatility index and AC z-score, MCA pulsatility index and AC z-score and ductus venosus pulsatility index z-score and AC z-score were, respectively: -0.36, p = 4.4 × 10(-7); 0.70, p = 1.1 × 10(-17) and -0.50, p = 8.1 × 10(-4). No relationship was seen between Doppler parameters and growth rate. There was no relationship between umbilical artery pulsatility index and AC nor growth rate in normally grown fetuses. In severe fetal growth restriction, Doppler changes are related to absolute fetal AC size, not growth rate.
Doppler 测量值、胎儿生长受限的大小和生长速度之间的关系尚未确定。我们使用功能线性判别分析（FLDA）来研究这些参数，同时考虑到从少数病例中探索重复观察结果之间关系所固有的困难。在 40 例严重生长受限的胎儿中，连续测量了腹围（AC）、脐动脉、大脑中动脉（MCA）和静脉导管多普勒搏动指数。在 11 例生长正常的单胎胎儿中，仅测量了脐动脉搏动指数。数据以与胎龄相关的 z 分数表示，并使用 FLDA 进行纵向分析。在严重生长受限中，脐动脉搏动指数与 AC z 分数、MCA 搏动指数与 AC z 分数和静脉导管搏动指数 z 分数与 AC z 分数之间的 Spearman 相关系数分别为：-0.36，p=4.4×10(-7)；0.70，p=1.1×10(-17)和-0.50，p=8.1×10(-4)。未观察到多普勒参数与生长速度之间存在关系。在生长正常的胎儿中，脐动脉搏动指数与 AC 之间以及与生长速度之间均无关系。在严重的胎儿生长受限中，多普勒变化与胎儿 AC 的绝对大小有关，而与生长速度无关。
