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个体调整胎儿生长的纵向研究。

Longitudinal study of individually adjusted fetal growth.

机构信息

Obstetric Clinic Division, University Hospital, University of São Paulo, São Paulo, Brazil.

Department of Obstetrics and Gynecology, Clinical Hospital, University of São Paulo, São Paulo, Brazil.

出版信息

Int J Gynaecol Obstet. 2020 Jan;148(1):35-40. doi: 10.1002/ijgo.12987. Epub 2019 Oct 16.

Abstract

OBJECTIVE

To construct individualized fetal growth curves estimated by ultrasound parameters adjusted for maternal and fetal characteristics.

METHODS

Data were retrospectively assessed from serial ultrasonographic examinations of singleton pregnancies at 12-42 gestational weeks among women without maternal or fetal conditions and full-term delivery at the University Hospital of University of São Paulo between July 1, 2014, and December 31, 2017. Measurements included biparietal diameter, head circumference, abdominal circumference, and femur length. Mixed linear regression was used to model the ultrasound biometric parameters as a function of gestational age, parity, maternal height, pre-pregnancy weight, and fetal sex.

RESULTS

In total, data were assessed from 1445 examinations of 434 pregnancies meeting the inclusion criteria. The estimated fetal weight model included gestational age, fetal sex, maternal height, and pre-pregnancy body mass index as covariates. The model enabled the construction of individual estimated fetal weight curves with respective percentiles covering 12-42 gestational weeks using maternal and fetal characteristics.

CONCLUSION

The growth curves, which are based on a sample of the Brazilian population with low risk of maternal or fetal morbidity and mortality, will make it possible to determine whether a fetus is achieving ideal growth potential according to maternal and fetal characteristics.

摘要

目的

构建通过调整母体和胎儿特征的超声参数来估计的个体化胎儿生长曲线。

方法

本研究回顾性评估了 2014 年 7 月 1 日至 2017 年 12 月 31 日期间在巴西圣保罗大学附属医院,于 12-42 孕周进行的、无母体或胎儿异常且足月分娩的单胎妊娠的连续超声检查中的数据。测量指标包括双顶径、头围、腹围和股骨长。采用混合线性回归来模拟超声生物参数作为胎龄、产次、母体身高、孕前体重和胎儿性别等因素的函数。

结果

共评估了符合纳入标准的 434 例妊娠的 1445 次检查的数据。估计胎儿体重模型包括胎龄、胎儿性别、母体身高和孕前体重指数作为协变量。该模型能够利用母体和胎儿特征构建涵盖 12-42 孕周的个体化估计胎儿体重曲线及其相应百分位数。

结论

这些生长曲线是基于巴西低母体和胎儿发病率和死亡率风险人群的样本构建的,将能够根据母体和胎儿特征来确定胎儿是否达到理想的生长潜力。

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