孕20至24周时脑胎盘比值低可预测孕期后期或出生时胎儿体重减轻。

A Low Cerebroplacental Ratio at 20-24 Weeks of Gestation Can Predict Reduced Fetal Size Later in Pregnancy or at Birth.

作者信息

Hernandez-Andrade Edgar, Maymon Eli, Erez Offer, Saker Homam, Luewan Suchaya, Garcia Maynor, Ahn Hyunyoung, Tarca Adi L, Done Bogdan, Korzeniewski Steven J, Hassan Sonia S, Romero Roberto

机构信息

Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, MD and Detroit, MI, USA.

出版信息

Fetal Diagn Ther. 2018;44(2):112-123. doi: 10.1159/000479684. Epub 2017 Sep 20.

DOI:10.1159/000479684

PMID:28926826

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5988962/

Abstract

AIM

To determine whether Doppler evaluation at 20-24 weeks of gestation can predict reduced fetal size later in pregnancy or at birth.

METHODS

Fetal biometry and Doppler velocimetry were performed in 2,986 women with a singleton pregnancy at 20-24 weeks of gestation. Predictive performances of the umbilical artery pulsatility index (UA-PI) or the mean uterine artery pulsatility index (UtA-PI) >95th percentile, middle cerebral artery pulsatility index, or cerebroplacental ratio (CPR) <5th percentile for early small for gestational age (SGA; <34 weeks of gestation), late SGA (≥34 weeks of gestation), or SGA at birth (birthweight <10th percentile) were analyzed.

RESULTS

The prevalence of early SGA, late SGA, and SGA at birth was 1.1, 9.6, and 14.7%, respectively. A CPR <5th percentile had a positive likelihood ratio (LR+) of 8.2 (95% confidence interval [CI] 5.7-12.0) for early SGA, a LR+ of 1.6 (95% CI 1.1-1.2) for late SGA, and a LR+ of 1.9 (95% CI 1.4-2.6) for SGA at birth. A UtA-PI >95th percentile was associated with late SGA and SGA at birth, while an UA-PI >95th percentile was associated with early SGA. Associations were higher in fetuses with an estimated fetal weight <10th percentile.

CONCLUSION

Fetal biometry and Doppler evaluation at 20-24 weeks of gestation can predict early and late SGA as well as SGA at birth.

摘要

目的

确定妊娠20 - 24周时的多普勒评估能否预测妊娠后期或出生时胎儿生长受限。

方法

对2986例单胎妊娠且妊娠20 - 24周的妇女进行胎儿生物测量和多普勒血流速度测定。分析脐动脉搏动指数（UA-PI）或平均子宫动脉搏动指数（UtA-PI）>第95百分位数、大脑中动脉搏动指数或脑胎盘比率（CPR）<第5百分位数对早期小于胎龄儿（SGA；妊娠<34周）、晚期SGA（≥34周）或出生时SGA（出生体重<第10百分位数）的预测性能。

结果

早期SGA、晚期SGA和出生时SGA的发生率分别为1.1%、9.6%和14.7%。CPR<第5百分位数对早期SGA的阳性似然比（LR+）为8.2（95%置信区间[CI]5.7 - 12.0），对晚期SGA为1.6（95%CI1.1 - 1.2），对出生时SGA为1.9（95%CI1.4 - 2.6）。UtA-PI>第95百分位数与晚期SGA和出生时SGA相关，而UA-PI>第95百分位数与早期SGA相关。在估计胎儿体重<第10百分位数的胎儿中，相关性更高。