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不明原因的颈项透明层增厚与不良妊娠结局的关系。

Association between unexplained thickened nuchal translucency and adverse pregnancy outcomes.

机构信息

Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.

出版信息

Arch Gynecol Obstet. 2018 Jul;298(1):97-101. doi: 10.1007/s00404-018-4790-9. Epub 2018 May 19.

Abstract

OBJECTIVE

To determine the association between unexplained increased nuchal translucency (INT) and adverse pregnancy outcomes.

PATIENTS AND METHODS

The prospective database of our fetal down screening project was accessed to retrieve the records with NT measurement and complete follow-up. Pregnancies with pre-existing medical diseases, fetal chromosomal or structural abnormalities were excluded. The selected pregnancies were classified into the INT groups (> 95th percentile), the normal (< 95th percentile) group.

RESULTS

Of 6026 available for analysis (INT:277; and normal: 5749), the abortion rate was significantly higher in the INT group, 18/277 (6.5%) versus 55/5749 (1.0%); p < 0.001. After excluding 73 cases ending-up with abortion, a total of 5953 women were analyzed for final pregnancy outcomes, including 260 (4.4%), and 5693 (95.6%) in the study group (INT), and the control group (normal NT), respectively. The rates of pre-eclampsia (7.3 vs. 4.1%; p: 0.018), preterm birth (12.7 vs. 8.4%; p: 0.023), fetal growth restriction (11.5 vs. 7.6%; p: 0.032), and low birth weight (16.5 vs. 10.0%; p: 0.002) were slightly, but significantly higher in the study group.

CONCLUSIONS

INT in the first trimester is associated with significantly increased risk of abortion, fetal growth restriction, preterm birth, low birth weight and pre-eclampsia.

摘要

目的

确定不明原因颈项透明层(NT)增厚与不良妊娠结局之间的关系。

患者与方法

本研究通过检索我们的胎儿唐氏筛查项目的前瞻性数据库,获取具有 NT 测量和完整随访的记录。排除患有先前存在的医学疾病、胎儿染色体或结构异常的妊娠。选择的妊娠分为 NT 增厚组(>95 百分位)和正常组(<95 百分位)。

结果

在 6026 例可分析的病例中(INT:277 例,正常:5749 例),INT 组的流产率显著更高,18/277(6.5%)比 55/5749(1.0%);p<0.001。排除 73 例流产病例后,共有 5953 例妇女分析最终妊娠结局,包括研究组(INT)的 260 例(4.4%)和对照组(正常 NT)的 5693 例(95.6%)。子痫前期的发生率(7.3%比 4.1%;p:0.018)、早产的发生率(12.7%比 8.4%;p:0.023)、胎儿生长受限的发生率(11.5%比 7.6%;p:0.032)和低出生体重儿的发生率(16.5%比 10.0%;p:0.002)在研究组中略高,但差异有统计学意义。

结论

早孕期 NT 增厚与流产、胎儿生长受限、早产、低出生体重和子痫前期的风险显著增加相关。

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