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母亲感知的胎儿运动质量和模式与晚期死胎的关系。

Association between maternally perceived quality and pattern of fetal movements and late stillbirth.

机构信息

Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.

Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.

出版信息

Sci Rep. 2019 Jul 8;9(1):9815. doi: 10.1038/s41598-019-46323-4.

Abstract

We investigated fetal movement quality and pattern and association with late stillbirth in this multicentre case-control study. Cases (n = 164) had experienced a non-anomalous singleton late stillbirth. Controls (n = 569) were at a similar gestation with non-anomalous singleton ongoing pregnancy. Data on perceived fetal movements were collected via interviewer-administered questionnaire. We compared categorical fetal movement variables between cases and controls using multivariable logistic regression, adjusting for possible confounders. In multivariable analysis, maternal perception of the following fetal movement variables was associated with decreased risk of late stillbirth; multiple instances of 'more vigorous than usual' fetal movement (aOR 0.52, 95% CI 0.32-0.82), daily perception of fetal hiccups (aOR 0.28, 95%CI 0.15-0.52), and perception of increased length of fetal movement clusters or 'busy times' (aOR 0.23, 95%CI 0.11-0.47). Conversely, the following maternally perceived fetal movement variables were associated with increased risk of late stillbirth; decreased frequency of fetal movements (aOR 2.29, 95%CI 1.31-4.0), and perception of 'quiet or light' fetal movement in the evening (aOR 3.82, 95%CI 1.57-9.31). In conclusion, women with stillbirth were more likely than controls to have experienced alterations in fetal movement, including decreased strength, frequency and in particular a fetus that was 'quiet' in the evening.

摘要

我们在这项多中心病例对照研究中调查了胎儿运动质量和模式及其与晚期死胎的关联。病例组(n=164)经历了非异常的单胎晚期死胎。对照组(n=569)在类似的孕龄有非异常的单胎继续妊娠。通过访谈员管理的问卷收集了感知胎儿运动的数据。我们比较了病例组和对照组之间的分类胎儿运动变量,使用多变量逻辑回归调整了可能的混杂因素。在多变量分析中,以下胎儿运动变量的母体感知与晚期死胎的风险降低相关:多次“比平时更剧烈”的胎儿运动(aOR 0.52,95%CI 0.32-0.82)、每天感知胎儿打嗝(aOR 0.28,95%CI 0.15-0.52),以及感知胎儿运动群或“忙碌时间”的长度增加(aOR 0.23,95%CI 0.11-0.47)。相反,以下母体感知的胎儿运动变量与晚期死胎的风险增加相关:胎儿运动频率降低(aOR 2.29,95%CI 1.31-4.0),以及傍晚感知胎儿“安静或轻柔”的运动(aOR 3.82,95%CI 1.57-9.31)。总之,与对照组相比,死胎孕妇更有可能经历胎儿运动的改变,包括力量、频率降低,特别是胎儿在晚上“安静”。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/600f/6614481/51c978b2414e/41598_2019_46323_Fig1_HTML.jpg

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