Gabbay-Benziv Rinat, Aviram Amir, Hadar Eran, Chen Rony, Bardin Ron, Wiznitzer Arnon, Yogev Yariv
a Helen Schneider Hospital for Women, Sackler Faculty of Medicine, Rabin Medical Center, Tel Aviv University , Tel Aviv , Israel and.
b Lis Maternity Hospital, Sackler Faculty of Medicine, The Tel-Aviv Sourasky Medical Center, Tel Aviv University , Tel Aviv , Israel.
J Matern Fetal Neonatal Med. 2017 Aug;30(16):1916-1919. doi: 10.1080/14767058.2016.1232383. Epub 2016 Sep 21.
To evaluate pregnancy outcome following false diagnosis of fetal growth restriction (FGR).
Retrospective analysis of all singleton term deliveries of appropriately grown fetuses (10-90th weight percentiles) in a single medical center (2007-2014). Elective cesarean-section, diabetes, and hypertension were excluded. Cohort was stratified based on third trimester sonographic estimated-fetal-weight (≥32 weeks). Women with false diagnosis FGR (<10th percentile) were compared with the rest (control). Induction of labor, cesarean deliveries, and short-term perinatal outcome were compared. Logistic regression analysis was performed to adjust outcome for birth weight and gestational age at delivery.
Of 34,474 pregnancies, 415 were falsely diagnosed as FGR (1.2%). Women in study group delivered earlier (38.6 ± 1.1 versus. 39.0 ± 0.9) with lower birth weights (2856 ± 270 versus 3271 ± 307 grams) and increased rate of labor inductions (19.8% versus 6.4%) and cesarean deliveries (10.8% versus 5.7%). Despite appropriate birth weight, study group neonates had higher rates of NICU admissions (10.6% versus 6.8%), mechanical ventilation (1.7% versus 0.5%), transient tachypnea of the newborn (1.7% versus 0.5%), hypoglycemia (1.7% versus 0.5%), and jaundice (11.3% versus 7.0%). p < 0.01 for all. All remained significant after adjustment to confounders.
False diagnosis of FGR is associated with higher rates of induction of labor, cesarean deliveries, and short-term adverse neonatal outcome.
评估胎儿生长受限（FGR）误诊后的妊娠结局。
对某单一医疗中心（2007 - 2014年）所有足月单胎分娩的胎儿生长正常（体重百分位数在10 - 90之间）的病例进行回顾性分析。排除择期剖宫产、糖尿病和高血压病例。根据孕晚期超声估计胎儿体重（≥32周）对队列进行分层。将误诊为FGR（<第10百分位数）的女性与其余女性（对照组）进行比较。比较引产、剖宫产及短期围产期结局。进行逻辑回归分析以调整分娩时出生体重和孕周对结局的影响。
在34474例妊娠中，415例被误诊为FGR（1.2%）。研究组女性分娩孕周更早（38.6±1.1 vs. 39.0±0.9），出生体重更低（2856±270 vs. 3271±307克），引产率（19.8% vs. 6.4%）和剖宫产率（10.8% vs. 5.7%）升高。尽管出生体重正常，但研究组新生儿入住新生儿重症监护病房（NICU）的比例更高（10.6% vs. 6.8%）、机械通气比例更高（1.7% vs. 0.5%）、新生儿短暂性呼吸急促比例更高（1.7% vs. 0.5%）、低血糖比例更高（1.7% vs. 0.5%）及黄疸比例更高（11.3% vs. 7.0%）。所有差异均p<0.01。在对混杂因素进行调整后，所有差异仍具有统计学意义。
FGR误诊与引产率、剖宫产率升高及短期不良新生儿结局相关。
