Sotiriadis Alexandros, Eleftheriades Makarios, Chatzinikolaou Fotios, Hassiakos Demetrios, Chrousos George P, Pervanidou Panagiota
Second Department of Obstetrics and Gynecology, "Hippokrateion" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
First Department of Pediatrics, School of Medicine, "Aghia Sophia" Children's Hospital, University of Athens, Athens, Greece.
Eur J Clin Invest. 2016 May;46(5):425-33. doi: 10.1111/eci.12611. Epub 2016 Mar 22.
Foetal growth monitoring is an essential component of prenatal care with postnatal impact. The aim of the study was to construct reference ranges for foetal biometric parameters in Greek foetuses and to compare them with previously published models.
Measurements from 1200 Greek foetuses were used to construct normal curves for biparietal diameter (BPD), occipitofrontal diameter (OFD), head circumference (HC), abdominal circumference (AC), femoral length (FL) and the BPD/FL ratio according to the methodology described by Royston and Wright (1998). The model was validated in a second group of 1200 different foetuses using analysis of the corresponding standardized residuals (z-scores). The z-scores which were derived by our model were compared to those calculated using previously published models from other populations.
BPD, OFD, HC, AC, FL and the BPD/FL ratio are accurately described by simple quadratic equations (R(2) > 0·96 for most of the parameters tested). Statistically significant differences were observed for most of the z-scores when our models were compared to previously published models. Less than 10% of our foetuses were < 5th or > 95th centile of the latter models. About 10% of our foetuses were > 95th centile for FL and HC when the INTERGROWTH-21st formulas were used.
We present national foetal biometric references. Using charts from other populations (including INTERGROWTH-21st) may be unrepresentative of local populations and lead to misclassification of foetal growth status.
胎儿生长监测是产前护理的重要组成部分,对产后也有影响。本研究的目的是构建希腊胎儿生物测量参数的参考范围,并将其与先前发表的模型进行比较。
根据Royston和Wright(1998年)描述的方法,使用1200例希腊胎儿的测量数据构建双顶径(BPD)、枕额径(OFD)、头围(HC)、腹围(AC)、股骨长度(FL)和BPD/FL比值的正态曲线。使用相应标准化残差(z分数)分析,在另一组1200例不同胎儿中对该模型进行验证。将我们模型得出的z分数与使用其他人群先前发表的模型计算得出的z分数进行比较。
BPD、OFD、HC、AC、FL和BPD/FL比值可用简单二次方程准确描述(大多数测试参数的R²>0.96)。当将我们的模型与先前发表的模型进行比较时,大多数z分数存在统计学显著差异。我们的胎儿中,不到10%处于后一种模型的第5百分位数以下或第95百分位数以上。当使用INTERGROWTH-21st公式时,我们约10%的胎儿的FL和HC处于第95百分位数以上。
我们给出了全国性的胎儿生物测量参考值。使用其他人群的图表(包括INTERGROWTH-21st)可能无法代表当地人群,并可能导致胎儿生长状况的错误分类。