Servicio de Obstetricia y Ginecologia, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
Ultrasound Obstet Gynecol. 2015 Feb;45(2):156-61. doi: 10.1002/uog.14647. Epub 2015 Jan 5.
To determine whether small- and appropriate-for-gestational-age (SGA and AGA) term fetuses with a low cerebroplacental ratio (CPR) have worse neonatal acid-base status than those with normal CPR.
This was a retrospective study of 2927 term fetuses divided into groups according to birth-weight centile and CPR multiple of the median. The acid-base status at birth as determined by arterial and venous umbilical cord blood pH was compared between weight-centile groups with and without low CPR.
CPR was better correlated with umbilical cord blood pH (arterial pH, r(2) = 0.008, P < 0.0001 and venous pH, r(2) = 0.01, P < 0.0001) than was birth weight (arterial pH, r(2) = 0.001, P =0.180 and venous pH, r(2) = 0.005, P < 0.001). AGA fetuses with low CPR were more academic than were those with normal CPR (P = 0.0359 and 0.0006, respectively, for arterial and venous pH).
The findings of this study demonstrate that low CPR in AGA fetuses is an equally important marker of low neonatal pH secondary to placental underperfusion as is being SGA. Although the relative importance of low CPR and birth weight in identifying pregnancies at risk of placental hypoxemia and adverse fetal and neonatal outcome remains to be determined, this finding may be of particular value in the prediction and prevention of stillbirth and long-term neurodevelopmental disability.
确定小且符合胎龄（SGA 和 AGA）的脑胎盘比（CPR）低的足月胎儿的新生儿酸碱状态是否比正常 CPR 的胎儿差。
这是一项回顾性研究，共纳入 2927 例足月胎儿，根据体重百分位和 CPR 中位数倍数分为两组。通过动脉和静脉脐带血 pH 值比较体重百分位组中 CPR 低与不低的新生儿酸碱状态。
CPR 与脐带血 pH 值（动脉 pH 值，r²=0.008，P<0.0001；静脉 pH 值，r²=0.01，P<0.0001）的相关性优于出生体重（动脉 pH 值，r²=0.001，P=0.180；静脉 pH 值，r²=0.005，P<0.001）。CPR 低的 AGA 胎儿比 CPR 正常的胎儿更酸中毒（动脉 pH 值，P=0.0359 和 0.0006；静脉 pH 值，P=0.0006 和 0.0006）。
本研究结果表明，与 SGA 一样，AGA 胎儿的低 CPR 是胎盘灌注不足导致新生儿低 pH 的重要标志。尽管低 CPR 和出生体重在识别胎盘缺氧和胎儿及新生儿不良结局风险方面的相对重要性仍有待确定，但这一发现对于预测和预防死产和长期神经发育障碍可能具有特别重要的意义。
