Al Hamayel Nebras Abu, Baghlaf Haitham, Blakemore Karin, Crino Jude P, Burd Irina
Department of Gynecology and Obstetrics, Johns Hopkins University, School of Medicine, 600 N Wolfe St, Phipps 228, Baltimore, MD 21287 USA.
Matern Health Neonatol Perinatol. 2020 Feb 20;6:1. doi: 10.1186/s40748-020-0115-7. eCollection 2020.
To determine whether there is a relationship between abnormal umbilical artery Doppler studies (UADS) and small for gestational age (SGA) birth weight and other adverse perinatal outcomes in fetuses that appear normally grown by ultrasound.
This was a retrospective study of all women who had UADS performed at or after 26 weeks of gestation at our institution between January 2005 and December 2012. Women were excluded if they had a fetal demise, a fetus with growth restriction, a fetus with congenital anomaly, or a multiple gestation. Women with missing delivery outcomes were excluded. The primary outcome was birth weight below the 10th percentile.
There were 2744 women included in the study. Of those, 98 (3.6%) had an abnormal UADS, and 379 (13.8%) had an SGA neonate. Of the 2646 women who had a normal UADS, 353 (13.3%) women had an SGA neonate. Twenty-six (26.5%) of the 98 women who had an abnormal UADS had an SGA neonate. After adjusting for potential confounders, the adjusted odds ratio for an SGA neonate with an abnormal UADS was 2.2 (95% CI, 1.38-3.58; < 0.05). In examining other adverse perinatal outcomes, neonatal intensive care unit (NICU) admission and low 5-min Apgar scores were 12.4 and 2.3%, respectively. The adjusted odds ratio for NICU admission was 1.84 (95% CI, 1.06-3.21; < 0.05). Abnormal UADS was not associated with low Apgar scores (aOR 1.39: 95% CI 0.47-4.07; > 0.05).
Our data suggest that abnormal UADS in fetuses that appear normally grown by ultrasound are associated with SGA neonates and NICU admission.
确定超声检查显示生长正常的胎儿中，脐动脉多普勒检查异常（UADS）与小于胎龄儿（SGA）出生体重及其他不良围产期结局之间是否存在关联。
这是一项对2005年1月至2012年12月期间在本机构妊娠26周及以后接受UADS检查的所有女性进行的回顾性研究。如果女性出现胎儿死亡、胎儿生长受限、胎儿先天性异常或多胎妊娠，则将其排除。分娩结局缺失的女性也被排除。主要结局是出生体重低于第10百分位数。
共有2744名女性纳入研究。其中，98名（3.6%）UADS异常，379名（13.8%）新生儿为SGA。在2646名UADS正常的女性中，353名（13.3 %）女性新生儿为SGA。98名UADS异常的女性中有26名（26.5%）新生儿为SGA。在对潜在混杂因素进行校正后，UADS异常的新生儿为SGA的校正比值比为2.2（95%CI，1.38 - 3.58；<0.05）。在检查其他不良围产期结局时，新生儿重症监护病房（NICU）入院率和5分钟Apgar评分低分别为12.4%和2.3%。NICU入院的校正比值比为1.84（95%CI，1.06 - 3.21；<0.05）。UADS异常与低Apgar评分无关（校正比值比1.39：95%CI 0.47 - 4.07；>0.05）。
我们的数据表明，超声检查显示生长正常的胎儿中，UADS异常与SGA新生儿及NICU入院有关。
