Şahin Uysal Nihal, Gülümser Çağrı, Bilgin Yanık Filiz
Department of Obstetrics and Gynecology, Division of Perinatology, Başkent University Ankara Hospital, Ankara, Turkey.
J Turk Ger Gynecol Assoc. 2017 Jun 1;18(2):90-95. doi: 10.4274/jtgga.2016.0228. Epub 2017 Mar 11.
To analyze the maternal and perinatal characteristics of small-for-gestational-age (SGA) newborns compared with appropriate-for-gestational-age (AGA) newborns in singleton pregnancies managed at our hospital between January 2006 and December 2015.
The study (n=456) and control (n=4925) groups included pregnancies resulting in SGA and AGA newborns, respectively. Additionally, two SGA subgroups were defined according to abnormal (n=34) and normal (n=57) Doppler findings. Maternal demographic features; intracytoplasmic sperm injection (ICSI) pregnancies; gestational age at delivery; birth weight; major congenital anomalies, karyotype abnormalities, and genetic syndromes; maternal and obstetric problems such as hypertensive disorders, diabetes, oligohydramnios, preterm birth; admission to the neonatal intensive care unit (NICU), and perinatal mortality were recorded, and the two groups were compared with respect to these parameters.
Mean maternal age, parity, gestational age at delivery, and birthweight were significantly lower; the frequencies of ICSI pregnancies, hypertensive disorders, oligohydramnios, preterm delivery, major congenital anomalies, karyotype abnormalities and genetic syndromes, admission to the NICU and perinatal mortality were significantly higher in the study group (p<0.05). None of the study parameters were significantly different between the two SGA subgroups (p>0.05).
The association of SGA with ICSI pregnancies, hypertensive disorders, oligohydramnios, preterm delivery, congenital/chromosomal anomalies, NICU admission and perinatal mortality may be important in perinatal care. Clinical suspicion of SGA necessitates appropriate monitorization and management. Although obstetric outcomes were not significantly different between the two SGA subgroups with abnormal and normal Doppler findings in this study, this finding must be evaluated with caution due to the small sizes.
分析2006年1月至2015年12月在我院管理的单胎妊娠中,小于胎龄儿(SGA)新生儿与适于胎龄儿(AGA)新生儿的母亲及围产期特征。
研究组(n = 456)和对照组(n = 4925)分别包括分娩出SGA和AGA新生儿的妊娠。此外,根据异常(n = 34)和正常(n = 57)的多普勒检查结果定义了两个SGA亚组。记录母亲的人口统计学特征;卵胞浆内单精子注射(ICSI)妊娠;分娩时的孕周;出生体重;主要先天性异常、核型异常和遗传综合征;母亲和产科问题,如高血压疾病、糖尿病、羊水过少、早产;入住新生儿重症监护病房(NICU)情况以及围产期死亡率,并比较两组在这些参数方面的差异。
研究组母亲的平均年龄、产次、分娩时孕周和出生体重显著较低;ICSI妊娠、高血压疾病、羊水过少、早产、主要先天性异常、核型异常和遗传综合征、入住NICU以及围产期死亡率的发生率显著较高(p<0.05)。两个SGA亚组之间的所有研究参数均无显著差异(p>0.05)。
SGA与ICSI妊娠、高血压疾病、羊水过少、早产、先天性/染色体异常、入住NICU和围产期死亡率之间的关联在围产期护理中可能很重要。临床怀疑SGA需要进行适当的监测和管理。尽管在本研究中,多普勒检查结果异常和正常的两个SGA亚组之间的产科结局无显著差异,但由于样本量小,这一发现必须谨慎评估。