O'Brien Cecelia M, Louise Jennie, Deussen Andrea, Dodd Jodie M
School of Paediatrics and Reproductive Health, and Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia.
School of Public Health, University of Adelaide, Adelaide, South Australia, Australia.
Aust N Z J Obstet Gynaecol. 2020 Feb;60(1):101-107. doi: 10.1111/ajo.13025. Epub 2019 Jul 10.
The aim of this study was to evaluate the association between fetal ultrasound and newborn biometry and adiposity measures in the setting of maternal obesity.
The study population involved 845 overweight or obese pregnant women, who participated in the Standard Care Group of the LIMIT randomised trial (ACTRN12607000161426, 9/03/2007). At 36 weeks gestation, fetal biometry, estimated fetal weight (EFW) and adiposity measures including mid-thigh fat mass (MTFM), subscapular fat mass (SSFM), and abdominal fat mass (AFM) were undertaken using ultrasound. Neonatal anthropometric measurements obtained after birth included birthweight, head circumference (HC), abdominal circumference (AC) and skinfold thickness measurements (SFTM) of the subscapular region and abdomen.
At 36 weeks gestation, every 1 g increase in EFW was associated with a 0.94 g increase in birthweight (95% CI 0.88-0.99; P < 0.001). For every 1 mm increase in the fetal ultrasound measure, there was a 0.69 mm increase in birth HC (95% CI 0.63-0.75, P < 0.001) and 0.69 mm increase in birth AC (95% CI 0.60-0.79, P < 0.001). Subscapular fat mass in the fetus and the newborn (0.29 mm, 95% CI 0.20-0.39, P < 0.001) were moderately associated, but AFM measurements were not (0.06 mm, -0.03 to 0.15, P = 0.203). There is no evidence that these relationships differed by maternal body mass index.
In women who are overweight or obese, fetal ultrasound accurately predicts neonatal HC and AC along with birthweight.
本研究旨在评估孕妇肥胖情况下胎儿超声与新生儿生物测量及肥胖指标之间的关联。
研究人群包括845名超重或肥胖孕妇，她们参与了LIMIT随机试验的标准护理组（ACTRN12607000161426，2007年3月9日）。在妊娠36周时，采用超声测量胎儿生物指标、估计胎儿体重（EFW）以及肥胖指标，包括大腿中部脂肪量（MTFM）、肩胛下脂肪量（SSFM）和腹部脂肪量（AFM）。出生后获得的新生儿人体测量数据包括出生体重、头围（HC）、腹围（AC）以及肩胛下区域和腹部的皮褶厚度测量值（SFTM）。
在妊娠36周时，EFW每增加1克，出生体重增加0.94克（95%可信区间0.88 - 0.99；P < 0.001）。胎儿超声测量值每增加1毫米，出生时HC增加0.69毫米（95%可信区间0.63 - 0.75，P < 0.001），出生时AC增加0.69毫米（95%可信区间0.60 - 0.79，P < 0.001）。胎儿和新生儿的肩胛下脂肪量（0.29毫米，95%可信区间0.20 - 0.39，P < 0.001）呈中度相关，但AFM测量值无相关性（0.06毫米，-0.03至0.15，P = 0.203）。没有证据表明这些关系因孕妇体重指数不同而有所差异。
在超重或肥胖女性中，胎儿超声可准确预测新生儿HC、AC以及出生体重。
