Crimmins Sarah, Mo Cecilia, Nassar Yomna, Kopelman Jerome N, Turan Ozhan M
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, Maryland.
George Washington University School of Medicine, Washington, District of Columbia.
Am J Perinatol. 2018 Jan;35(2):140-145. doi: 10.1055/s-0037-1606186. Epub 2017 Aug 24.
This study aims to investigate the perinatal outcome of fetuses with polyhydramnios and/or accelerated growth among women with a normal oral glucose challenge test (oGCT).
Singleton, nonanomalous pregnancies with an oGCT(< 130 mg/dL) at 24 to 28 weeks, who subsequently demonstrate polyhydramnios (amniotic fluid index > 24 cm or maximum vertical pocket > 8 cm) and/or accelerated growth (abdominal circumference > 95th percentile) on two-third trimester examinations were studied. Maternal demographics, delivery, and neonatal information were recorded. Cases were compared with a reference group (normal oGCT with neither abnormal third-trimester growth nor polyhydramnios).
A total of 282 pregnancies were in the study group, and 663 were in the reference group. Deliveries in the study group were at a higher risk for birth weight (BW)% > 90%, standard deviation, and postpartum hemorrhage when compared with the reference group (adjusted odds ratio: 2.3-5.6). Pregnancies complicated by both polyhydramnios and accelerated fetal growth were significantly more likely to result in a BW% > 90% (odds ratio [OR]: 18.5; 95% confidence interval [CI]: 8.9-38.6) and PPH (OR: 4.2; 95% CI: 2.4-7.6).
Pregnancies with normal oGCT that develop polyhydramnios and accelerated growth are at higher risk for maternal and neonatal complications. Isolated polyhydramnios without accelerated growth increases the risk for delivery complications but not neonatal morbidity.
本研究旨在调查口服葡萄糖耐量试验（oGCT）正常的女性中羊水过多和/或胎儿生长加速的围产期结局。
对24至28周时oGCT（<130mg/dL）的单胎、非畸形妊娠进行研究，这些妊娠在孕晚期两次检查中随后出现羊水过多（羊水指数>24cm或最大垂直深度>8cm）和/或生长加速（腹围>第95百分位数）。记录产妇人口统计学、分娩和新生儿信息。将病例与对照组（oGCT正常且孕晚期生长无异常及无羊水过多）进行比较。
研究组共有282例妊娠，对照组有663例。与对照组相比，研究组分娩时出生体重（BW）>90%、标准差及产后出血的风险更高（校正比值比：2.3 - 5.6）。合并羊水过多和胎儿生长加速的妊娠更易导致BW>90%（比值比[OR]：18.5；95%置信区间[CI]：8.9 - 38.6）和产后出血（OR：4.2；95%CI：2.4 - 7.6）。
oGCT正常但出现羊水过多和生长加速的妊娠母婴并发症风险更高。单纯羊水过多而无生长加速会增加分娩并发症风险，但不会增加新生儿发病率。
