Department of Pediatrics, National Hospital Organization Beppu Medical Center, Beppu, Oita, Japan.
Department of Obstetrics and Gynecology, National Hospital Organization Beppu Medical Center, Beppu, Oita, Japan.
PLoS One. 2018 Oct 22;13(10):e0206002. doi: 10.1371/journal.pone.0206002. eCollection 2018.
Recent studies have indicated that birth weight to placental weight (BW/PW) ratio is related to perinatal outcomes, but the effect of congenital abnormalities on BW/PW ratio remains unclear. We performed this study to elucidate correlations between BW/PW ratio and congenital abnormalities. Subjects were 735 singleton infants born at 34-41 weeks of gestation admitted to our center between 2010 and 2016. Of these, 109 infants (15%) showed major congenital anomalies. Major congenital anomalies and subgroups were diagnosed according to European Surveillance of Congenital Anomalies criteria. The primary outcome was the association between BW/PW ratio and major congenital anomaly, and secondary outcomes were the distribution pattern of BW/PW ratio with major anomalies and by major anomaly subgroups in each categorization (<10th percentile, 10-90th percentile, or >90th percentile) of BW/PW ratio. BW/PW ratio was not associated (P = 0.20) with presence (adjusted mean BWPW ratio = 5.02, 95% confidence interval [CI] 4.87-5.18) or absence (adjusted mean BW/PW ratio = 4.91, 95%CI 4.85-4.97) of major anomalies, after adjusting for gestational age and sex. Proportions of infants with major anomalies according to BW/PW ratio categories were as follows: 12% in <10th percentile, 15% in 10-90th percentile, and 25% in >90th percentile of BW/PW ratio. Among major anomalies of the nervous system, congenital heart defects, and orofacial clefts, BW/PW ratio showed equally distributed trend across the three BW/PW ratio categories, but showed unequally distributed trend for anomalies of the digestive system, other anomalies/syndromes, or chromosomal abnormalities. BW/PW ratio was not associated with major congenital anomaly, and was distributed diffusely according to major anomaly subgroups. Major anomalies may tend to aggregate in the 90th percentile of the BW/PW ratio.
近期研究表明，出生体重与胎盘重量（BW/PW）比值与围产儿结局相关，但先天性异常对 BW/PW 比值的影响尚不清楚。我们开展此项研究旨在阐明 BW/PW 比值与先天性异常之间的相关性。研究对象为 2010 年至 2016 年期间在我院出生、胎龄 34-41 周的 735 例单胎婴儿，其中 109 例（15%）存在主要先天性异常。主要先天性异常及亚组根据欧洲先天性异常监测标准进行诊断。主要结局为 BW/PW 比值与主要先天性异常的相关性，次要结局为 BW/PW 比值与主要异常的分布模式以及根据 BW/PW 比值的主要异常亚组（BW/PW 比值<第 10 百分位数、10-90 百分位数或>第 90 百分位数）进行分类。调整胎龄和性别后，BW/PW 比值与主要异常的存在（调整后平均 BW/PW 比值=5.02，95%置信区间 [CI] 4.87-5.18）或不存在（调整后平均 BW/PW 比值=4.91，95%CI 4.85-4.97）均无关（P=0.20）。根据 BW/PW 比值分类，主要异常婴儿所占比例如下：BW/PW 比值<第 10 百分位数为 12%，10-90 百分位数为 15%，>第 90 百分位数为 25%。在神经系统、先天性心脏缺陷和口腔颌面裂等主要异常中，BW/PW 比值在三个 BW/PW 比值类别中呈均匀分布趋势，但在消化系统、其他异常/综合征或染色体异常中呈不均匀分布趋势。BW/PW 比值与主要先天性异常无关，且根据主要异常亚组呈弥漫性分布。主要异常可能倾向于聚集在 BW/PW 比值的第 90 百分位数。
