Turcan Natalia, Bohiltea Roxana Elena, Ionita-Radu Florentina, Furtunescu Florentina, Navolan Dan, Berceanu Costin, Nemescu Dragos, Cirstoiu Monica Mihaela
Department of Obstetrics and Gynecology, 'Carol Davila' University of Medicine and Pharmacy Doctoral School, University Emergency Hospital of Bucharest, 050098 Bucharest, Romania.
Department of Obstetrics and Gynecology, 'Carol Davila' University of Medicine and Pharmacy, University Emergency Hospital of Bucharest, 050098 Bucharest, Romania.
Exp Ther Med. 2020 Sep;20(3):2415-2422. doi: 10.3892/etm.2020.8744. Epub 2020 May 13.
Vascular stress at the level of the uterus-placental unit, with chronic placental ischemia, results in intrauterine growth restriction. Expectation management can be used, when the situation allows, in cases of compensated intrauterine growth restriction. The aim of the present study was to evaluate the neonatal prognosis of preterm births with and without growth restriction and term births with growth restriction in order to improve decisional accuracy regarding the termination of pregnancy. The frequency of term birth infants with low birth weight for gestational age was ~2%. The male sex, predominated only in the group of premature infants with normal weight for the gestational age. The highest frequency of neonatal complications studied occurred in the group of preterm neonates small for gestational age (SGA) with statistical significance obtained for cardiovascular arrest acute respiratory failure, ulcer-necrotic enterocolitis, respiratory distress, cerebral edema, intraventricular hemorrhage, cerebral hemorrhage, pulmonary hemorrhage, neonatal infection, hypoglycemia, retinopathy, anemia, hemorrhagic disease, disseminated intravascular coagulation, disease of hyaline membranes, neonatal sepsis, need for intensive neonatal therapy and death. In conclusion, immediate neonatal adaptation of SGA preterm neonates is more deficient than for preterm neonates with appropriate weight for gestational age; the adaptation of preterm neonates, in turn, is more deficient than term newborns with intrauterine growth restriction. The term newborns with intrauterine growth restriction have a neonatal adaptation comparable to that of the term newborns with weight corresponding to the gestational age.
子宫 - 胎盘单位水平的血管应激,伴有慢性胎盘缺血,会导致宫内生长受限。在情况允许时,对于代偿性宫内生长受限的病例可采用预期管理。本研究的目的是评估有和没有生长受限的早产以及有生长受限的足月产的新生儿预后,以提高关于终止妊娠决策的准确性。孕周小于胎龄的足月产低体重儿的发生率约为2%。男性仅在孕周体重正常的早产组中占主导。所研究的新生儿并发症发生率最高的是孕周小于胎龄(SGA)的早产新生儿组,在以下方面具有统计学意义:心脏骤停、急性呼吸衰竭、溃疡坏死性小肠结肠炎、呼吸窘迫、脑水肿、脑室内出血、脑出血、肺出血、新生儿感染、低血糖、视网膜病变、贫血、出血性疾病、弥散性血管内凝血、透明膜病、新生儿败血症、需要新生儿重症治疗以及死亡。总之,SGA早产新生儿的即刻新生儿适应比孕周体重合适的早产新生儿更差;反过来,早产新生儿的适应比有宫内生长受限的足月新生儿更差。有宫内生长受限的足月新生儿的新生儿适应与孕周体重相符的足月新生儿相当。