Mazarico E, Martinez-Cumplido R, Díaz M, Sebastiani G, Ibáñez L, Gómez-Roig M D
BCN-Barcelona Center of Maternal-Fetal Medicine and Neonatology (Hospital Sant Joan de Déu and Hospital Clínic), Fetal i+D Fetal Medicine Research Center, Barcelona, Spain.
Spanish Maternal and Child Health Network, Retic SAMID, Institute Carlos III, Madrid, Spain.
PLoS One. 2016 Mar 3;11(3):e0150152. doi: 10.1371/journal.pone.0150152. eCollection 2016.
Infant anthropometry and body composition have been previously assessed to gauge the impact of intrauterine growth restriction (IUGR) at birth, but the interplay between prenatal Doppler measurements and postnatal development has not been studied in this setting. The present investigation was performed to assess the significance of prenatal Doppler findings relative to postnatal anthropometrics and body composition in IUGR newborns over the first 12 months of life.
Consecutive cases of singleton pregnancies with suspected IUGR were prospectively enrolled over 12 months. Fetal biometry and prenatal Doppler ultrasound examinations were performed. Body composition was assessed by absorptiometry at ages 10 days, and at 4 and 12 months.
A total of 48 pregnancies qualifying as IUGR were studied. Doppler parameters were normal in 26 pregnancies. The remaining 22 deviated from normal, marked by an Umbilical Artery Pulsatility Index (UA-PI) >95th centil or Cerebro-placental ratio (CPR) <5th centile. No significant differences emerged when comparing anthropometry and body composition at each time point, in relation to Doppler findings. Specifically, those IUGR newborns with and without abnormal Doppler findings had similar weight, length, body mass index, lean and fat mass, and bone mineral content throughout the first 12 months of life. In a separate analysis, when comparing IUGR newborns by Doppler (abnormal UA-PI vs. abnormal CPR), anthropometry and body composition did not differ significantly.
Infants with IUGR maintain a pattern of body composition during the first year of life that is independent of prenatal Doppler findings. Future studies with larger sample sizes and correlating with hormonal status are warranted to further extend the phenotypic characterization of the various conditions now classified under the common label of IUGR.
此前曾通过评估婴儿人体测量学指标和身体成分来衡量宫内生长受限（IUGR）对出生时的影响，但尚未在此背景下研究产前多普勒测量与产后发育之间的相互作用。本研究旨在评估产前多普勒检查结果对于IUGR新生儿出生后12个月内人体测量学指标和身体成分的意义。
在12个月期间前瞻性纳入连续的疑似IUGR单胎妊娠病例。进行胎儿生物测量和产前多普勒超声检查。在出生10天、4个月和12个月时通过吸收法评估身体成分。
共研究了48例符合IUGR标准的妊娠病例。26例妊娠的多普勒参数正常。其余22例偏离正常，以脐动脉搏动指数（UA-PI）>第95百分位数或脑胎盘比率（CPR）<第5百分位数为标志。在每个时间点比较人体测量学指标和身体成分时，与多普勒检查结果相比未发现显著差异。具体而言，在出生后的前12个月，有和没有异常多普勒检查结果的IUGR新生儿在体重、身长、体重指数、瘦体重、脂肪量和骨矿物质含量方面相似。在一项单独分析中，按多普勒检查结果（异常UA-PI与异常CPR）比较IUGR新生儿时，人体测量学指标和身体成分无显著差异。
IUGR婴儿在出生后第一年保持一种与产前多普勒检查结果无关的身体成分模式。有必要开展样本量更大且与激素状态相关的未来研究，以进一步扩展目前归类于IUGR这一共同标签下各种情况的表型特征描述。
