Ego A, Prunet C, Blondel B, Kaminski M, Goffinet F, Zeitlin J
Inserm UMR 1153, équipe de recherche en épidémiologie obstétricale, périnatale et pédiatrique (EPOPé), centre de recherche épidémiologie et statistique Sorbonne Paris-Cité, DHU risques et grossesse, université Paris-Descartes, 75014 Paris, France; Pôle santé publique, centre hospitalier universitaire de Grenoble, 38000 Grenoble, France.
Inserm UMR 1153, équipe de recherche en épidémiologie obstétricale, périnatale et pédiatrique (EPOPé), centre de recherche épidémiologie et statistique Sorbonne Paris-Cité, DHU risques et grossesse, université Paris-Descartes, 75014 Paris, France.
J Gynecol Obstet Biol Reprod (Paris). 2016 Feb;45(2):165-76. doi: 10.1016/j.jgyn.2015.08.008. Epub 2015 Oct 1.
Our aim is to compare the new French EPOPé intrauterine growth curves, developed to address the guidelines 2013 of the French College of Obstetricians and Gynecologists, with reference curves currently used in France, and to evaluate the consequences of their adjustment for fetal sex and maternal characteristics.
Eight intrauterine and birthweight curves, used in France were compared to the EPOPé curves using data from the French Perinatal Survey 2010. The influence of adjustment on the rate of SGA births and the characteristics of these births was analysed.
Due to their birthweight values and distribution, the selected intrauterine curves are less suitable for births in France than the new curves. Birthweight curves led to low rates of SGA births from 4.3 to 8.5% compared to 10.0% with the EPOPé curves. The adjustment for maternal and fetal characteristics avoids the over-representation of girls among SGA births, and reclassifies 4% of births. Among births reclassified as SGA, the frequency of medical and obstetrical risk factors for growth restriction, smoking (≥10 cigarettes/day), and neonatal transfer is higher than among non-SGA births (P<0.01).
The EPOPé curves are more suitable for French births than currently used curves, and their adjustment improves the identification of mothers and babies at risk of growth restriction and poor perinatal outcomes.
我们的目的是将为符合法国妇产科医师学会2013年指南而制定的新的法国EPOPé宫内生长曲线与法国目前使用的参考曲线进行比较,并评估对胎儿性别和母亲特征进行调整的后果。
使用2010年法国围产期调查的数据,将法国使用的八条宫内和出生体重曲线与EPOPé曲线进行比较。分析了调整对小于胎龄儿(SGA)出生发生率及其特征的影响。
由于其出生体重值和分布情况,所选的宫内曲线不如新曲线适用于法国的出生情况。出生体重曲线导致SGA出生发生率较低,为4.3%至8.5%,而EPOPé曲线为10.0%。对母亲和胎儿特征进行调整可避免SGA出生中女孩比例过高的情况,并对4% 的出生情况进行重新分类。在重新分类为SGA的出生中,生长受限的医学和产科危险因素、吸烟(≥10支/天)以及新生儿转运的发生率高于非SGA出生(P<0.01)。
EPOPé曲线比目前使用的曲线更适用于法国的出生情况,并且对其进行调整可改善对有生长受限风险和围产期结局不良的母亲和婴儿的识别。