Department of Perinatology and Gynecology, Poznan University of Medical Sciences, Poznan, Poland.
Department of General and Colorectal Surgery, Poznan University of Medical Sciences, Poznan, Poland.
Ginekol Pol. 2020;91(12):740-747. doi: 10.5603/GP.a2020.0125.
To create outcome dependent fetal growth curves and birth weight standards that can be analyzed for use in clinic specifically for Western European populations.
We conducted a retrospective study on fetal growth and birth weight trends from live birth singleton pregnancies between 2005 and 2018 at one of the largest tertiary gynecologic-obstetric hospitals in Poland. The inclusion criteria were at least 22 weeks of gestation at birth regardless of delivery mode (vaginal or C-section), no congenital anomalies diagnosed before and after delivery and an Apgar score of at least 7 in the first minute. The final sample had a total of 39,413 cases (18,562 girls and 20,851 boys). We presented 7 (for all fetuses in the 5th, 10th, 25th, 50th, 75th, 90th and 95th percentiles) and 6 (for boys and girls each at 10th, 50th and 90th percentiles) fetal growth curves between 25 and 40 weeks of gestation. Birth weight trends were obtained and analyzed from all babies in the 5th, 10th, 25th, 50th, 75th and 95th percentiles born between 22 to 42 weeks of gestation with also separate trends for boys and girls.
The largest differences in fetal growth curves were observed in the 10th and 50th percentiles between 22 and 34 weeks of gestation. A decreasing fetal weight gain pattern was observed between 27 and 30 weeks and after 38 weeks of gestation, the decrease was more drastic in female. A significant increase from 2009 to 2017 was observed in the weight of 50th percentile babies born at or after 35 weeks. We found significant discrepancies between our results and the most used European fetal growth curves particularly in the 10th and 90th percentile weights at 30 weeks.
Separate scales for boys and girls were implied and given the overall difference form commonly used references. We believe there is significant value in using these unique patterns found in fetal growth curves and birth weights of ethnically homogenous population (such as Poland) at everyday clinical practice for more opportunities of safe obstetric care and higher chances of delivering a healthy child.
为了创建依赖于结果的胎儿生长曲线和出生体重标准，这些标准可以在临床上进行分析，专门用于西欧人群。
我们对波兰最大的妇产医院之一 2005 年至 2018 年期间的活产单胎妊娠的胎儿生长和出生体重趋势进行了回顾性研究。纳入标准为出生时至少 22 周的妊娠，无论分娩方式（阴道分娩或剖宫产）如何，分娩前后无先天性畸形，出生后 1 分钟内阿普加评分为至少 7 分。最终样本共有 39413 例（女孩 18562 例，男孩 20851 例）。我们展示了 7 个（所有胎儿第 5、10、25、50、75 和 95 百分位）和 6 个（男孩和女孩各第 10、50 和 90 百分位）25 至 40 周之间的胎儿生长曲线。从所有 22 至 42 周出生的第 5、10、25、50、75 和 95 百分位的婴儿中获得并分析了出生体重趋势，也分别为男孩和女孩绘制了单独的趋势。
在 22 至 34 周之间，胎儿生长曲线的第 10 和 50 百分位之间的差异最大。在 27 至 30 周和 38 周后，胎儿体重增加模式呈下降趋势，女性的下降更为明显。从 2009 年到 2017 年，在 35 周或以上出生的 50 百分位婴儿的体重显著增加。我们发现，我们的结果与最常用的欧洲胎儿生长曲线之间存在显著差异，特别是在 30 周时第 10 和 90 百分位的体重。
为男孩和女孩分别制定了单独的标准，并与常用参考值形成整体差异。我们认为，在日常临床实践中使用这些在种族同质人群（如波兰）的胎儿生长曲线和出生体重中发现的独特模式具有重要价值，可以为安全的产科护理提供更多机会，并增加生育健康儿童的机会。
