Kawabata Kosuke, Morikawa Mamoru, Ishikawa Satoshi, Nakagawa Kinuko, Chiba Kentaro, Yamada Takahiro, Saito Yoshihiro, Akimoto Takuma, Cho Kazutoshi, Minakami Hisanori
Department of Perinatal Medicine, Hokkaido University Hospital, Japan.
Department of Perinatal Medicine, Hokkaido University Hospital, Japan.
Taiwan J Obstet Gynecol. 2019 Mar;58(2):212-217. doi: 10.1016/j.tjog.2019.01.008.
This study was performed to evaluate the application of fetal middle cerebral artery peak systolic velocity (MCA-PSV) for prediction of newborn anemia with umbilical cord blood hemoglobin concentration at birth (UCB-Hb) < 10.0 g/dL among infants born at gestational week (GW) ≥ 36 to unselected women.
We reviewed the medical charts of 699 women giving birth to singleton infants at GW ≥ 36 with available data on MCA-PSV measured at GW ≥ 25 at the discretion of the attending physician. Multiple of the median (MoM) MCA-PSV (MCA-PSV MoM) > 1.5 was defined as a positive MCA-PSV test result.
The MCA-PSV test was applied 2309 times (313 and 1996 times during second and third trimesters, respectively) in 699 women. The results were positive in 4.4% (102/2309) of tests and at least once in 9.9% (69/699) of women. Anemic infants were born to one (1.4%) and six (1.0%) of 69 and 630 women with and without at least one positive test result, respectively. MoM determined 4, 3, and 2 weeks before birth showed significant weak negative correlations with UCB-Hb at birth (correlation coefficient: 0.298-0.325).
Among unselected women giving birth at or near term, the MCA-PSV test was unsatisfactory for prediction of newborn anemia in this retrospective observational study.
本研究旨在评估胎儿大脑中动脉收缩期峰值流速（MCA-PSV）在预测孕周（GW）≥36周、未经过筛选的孕妇所分娩婴儿出生时脐血血红蛋白浓度（UCB-Hb）<10.0 g/dL的新生儿贫血中的应用。
我们回顾了699例GW≥36周分娩单胎婴儿的妇女的病历，这些病历中有主治医生酌情在GW≥25周时测量的MCA-PSV数据。将MCA-PSV的中位数倍数（MoM）>1.5定义为MCA-PSV检测结果阳性。
699例妇女中，MCA-PSV检测共进行了2309次（分别在孕中期和孕晚期进行了313次和1996次）。检测结果阳性率为4.4%（102/2309），9.9%（69/699）的妇女至少有一次检测结果阳性。在至少有一次检测结果阳性的69例妇女和没有阳性检测结果的630例妇女中，分别有1例（1.4%）和6例（1.0%）分娩出贫血婴儿。出生前4、3和2周测定的MoM与出生时的UCB-Hb呈显著弱负相关（相关系数：0.298 - 0.325）。
在本回顾性观察研究中，对于孕周足月或接近足月分娩的未经过筛选的孕妇，MCA-PSV检测在预测新生儿贫血方面效果不佳。
