Fetal Medicine Unit,Instituto Nacional Materno Perinatal, Lima, Peru.
Department of Obstetrics and Gynecology, Virgen de la Arrixaca University Clinical Hospital, Murcia, Spain,
Fetal Diagn Ther. 2020;47(8):615-623. doi: 10.1159/000505779. Epub 2020 Feb 18.
To determine the contribution of short femur diaphysis length (FDL) at 19-22 weeks of gestation in the prediction of adverse pregnancy outcomes.
The study included singleton pregnant women who underwent a routine anomaly scan at 19-22 weeks of gestation at the Virgen de la Arrixaca University Clinical Hospital (Murcia, Spain) between August 2011 and August 2012. Fetal biometry and Doppler ultrasound of uterine arteries were assessed as part of the anomaly scan, and the mean pulsatility index of both uterine arteries was recorded. Maternal obstetric characteristics, such as ethnicity, age, weight, parity, cigarette smoking, and medical history including hypertension and diabetes mellitus were collected from our database system.
A total of 6,366 women were included in the study after excluding cases with abnormal karyotype, major fetal abnormalities, or termination of pregnancy. There were 88 cases of preeclampsia (PE) (1.4%). Logistic regression was performed including maternal and fetal characteristics. Short FDL at 19-22 weeks was significantly associated with subsequent development of PE (OR = 0.89, 95% CI: 0.80-0.99, p = 0.025). The best model to predict PE from our sample included gestational age at scan, parity, maternal weight, chronic hypertension, mean pulsatility index in the uterine arteries, and FDL (AUC = 0.78, 95% CI: 0.71-0.84). Regarding small for gestational age (SGA) neonates, there were also significant differences in FDL and FDL <5th centile between the control group and SGA newborns below the 3rd, 5th, and 10th centile. In the groups of preterm births (delivery before 32, 34, and 37 weeks), there were no differences in FDL compared with the control group (term births).
Our results suggest that FDL at 19-22 weeks of gestation is an independent predictor of PE and SGA newborns.
确定孕 19-22 周时股骨短（FDL）长度在预测不良妊娠结局中的作用。
本研究纳入了 2011 年 8 月至 2012 年 8 月期间在西班牙穆尔西亚的 Virgen de la Arrixaca 大学临床医院接受 19-22 周常规异常扫描的单胎孕妇。作为异常扫描的一部分，评估了胎儿生物测量和子宫动脉多普勒超声，并记录了双侧子宫动脉的平均搏动指数。从我们的数据库系统中收集了母体产科特征，如种族、年龄、体重、产次、吸烟情况以及包括高血压和糖尿病在内的病史。
在排除了异常核型、严重胎儿异常或终止妊娠的病例后，共有 6366 名女性纳入研究。共有 88 例（1.4%）子痫前期（PE）病例。进行了包括母体和胎儿特征的逻辑回归。孕 19-22 周时 FDL 短与随后发生的 PE 显著相关（OR=0.89，95%CI：0.80-0.99，p=0.025）。从我们的样本中预测 PE 的最佳模型包括扫描时的孕龄、产次、母体体重、慢性高血压、子宫动脉平均搏动指数和 FDL（AUC=0.78，95%CI：0.71-0.84）。关于小于胎龄儿（SGA）新生儿，对照组与 SGA 新生儿在第 3、5 和 10 百分位以下的 FDL 和 FDL<第 5 百分位之间也存在显著差异。在早产（分娩在 32、34 和 37 周之前）组中，与对照组（足月分娩）相比，FDL 无差异。
我们的结果表明，孕 19-22 周时 FDL 是 PE 和 SGA 新生儿的独立预测因素。
