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足月时胎动减少、低危妊娠:是否与不良妊娠结局相关?单中心十年经验。

Reduced fetal movements at term, low-risk pregnancies: is it associated with adverse pregnancy outcomes? Ten years of experience from a single tertiary center.

机构信息

Department of Obstetrics and Gynecology, The Edith Wolfson Medical Center (affiliated with Sackler Faculty of Medicine, Tel Aviv University), Tel Aviv, P.O Box 5, 58100, Holon, Israel.

出版信息

Arch Gynecol Obstet. 2020 Apr;301(4):987-993. doi: 10.1007/s00404-020-05516-3. Epub 2020 Mar 20.

Abstract

OBJECTIVE

We aimed to assess the outcomes of low-risk pregnancies complicated by isolated reduced fetal movements (RFM) at term.

STUDY DESIGN

The study population were patients at term, with singleton, low-risk, pregnancies who presented to our obstetric-triage and delivered during the subsequent 2 weeks. The study group included patients with an isolated complaint of RFM (RFM group). The control group included patients without history of RFM (control group). The pregnancy, delivery, and neonatal outcomes were compared between the groups. Severe and mild composites of adverse neonatal outcomes were defined. Multivariate regression analyses were performed to identify independent association with adverse neonatal outcomes.

RESULTS

Among the 13,338 pregnant women, 2762 (20.7%) were included in the RFM group and 10,576 (79.3%) in the control group. The RFM group had higher rates of nulliparity (p < 0.001), and smoking (p < 0.001). At admission, the RFM group had higher rates of IUFD (p < 0.001). The RFM group had higher rates of Cesarean delivery due to non-reassuring fetal monitor (p < 0.001), and mild adverse neonatal outcomes (p = 0.001). RFM was associated with mild adverse outcome independent of background confounders (aOR = 1.4, 95% CI 1.2-2.6, p < 0.001).

CONCLUSION

Patients presented with isolated RFM at term had higher rates of IUFD at presentation and significant adverse outcomes at delivery.

摘要

目的

评估足月时单纯胎动减少(RFM)的低危妊娠结局。

研究设计

研究人群为足月、单胎、低危妊娠患者,在我院产科分诊就诊并在随后的 2 周内分娩。研究组为有孤立性 RFM 主诉的患者(RFM 组),对照组为无 RFM 病史的患者(对照组)。比较两组的妊娠、分娩和新生儿结局。定义严重和轻度不良新生儿结局综合指标。进行多变量回归分析以确定与不良新生儿结局的独立关联。

结果

在 13338 名孕妇中,2762 名(20.7%)被纳入 RFM 组,10576 名(79.3%)被纳入对照组。RFM 组初产妇比例较高(p<0.001),吸烟比例较高(p<0.001)。入院时,RFM 组胎儿宫内死亡(IUFD)发生率较高(p<0.001)。RFM 组因胎儿监护不明确行剖宫产的比例较高(p<0.001),轻度不良新生儿结局的发生率较高(p=0.001)。在调整了背景混杂因素后,RFM 与轻度不良结局独立相关(aOR=1.4,95%CI 1.2-2.6,p<0.001)。

结论

足月时出现孤立性 RFM 的患者就诊时 IUFD 发生率较高,分娩时不良结局显著。

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