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基于进化假说的骨盆与新生儿体型相关性

Pelvic and neonatal size correlations in light of evolutionary hypotheses.

作者信息

Frémondière Pierre, Thollon Lionel, Marchal François

机构信息

Aix Marseille Univ, School of Midwifery, Faculty of Medical and Paramedical Sciences, Marseille, France.

Aix Marseille Univ, CNRS, EFS, ADES, Marseille, France.

出版信息

Am J Hum Biol. 2022 Feb;34(2):e23619. doi: 10.1002/ajhb.23619. Epub 2021 May 24.

Abstract

OBJECTIVE

This study aimed to analyze the correlations between maternal size, neonatal size, and gestational variables.

METHODS

Our sample comprises 131 mother-infant dyads. We investigated correlations between five neonatal traits (gestational age, birthweight, head, suboccipito-brematic, and abdominal girths), three maternal traits (height, BMI, and uterus height), and three pelvic variables (conjugate, inter-spinous diameters, and sub-pubic angle) using computed tomography pelvimetry.

RESULTS

We found that the five neonatal traits were significantly intercorrelated. BMI was not correlated with neonatal traits while maternal height was correlated with birthweight, suboccipito-brematic, and abdominal girth. In the multiple regression models, gestational age was correlated with birthweight, head, and abdominal girth. Among the neonatal and pelvimetry correlations, conjugate diameter was slightly correlated with suboccipito-bregmatic girth, but inter-spinous and sub-pubic angle were not correlated with neonatal traits. Uterus height predicted all neonatal variables, but it was not correlated with gestational age.

DISCUSSION

Our results suggest that fetal growth is shaped by maternal phenotype rather than external ecological factors. The association of the inlet size with suboccipito-bregmatic girth reflects the tight fit between the neonatal brain and the maternal pelvis dimensions, an adaptation that would reduce the risk of cephalo-pelvic disproportion, while the absence of tight fit at the midplane and outlet could be due to the effect of the pelvic relaxation. Uterus distention is not the only mechanism involved in the initiation of parturition. Birth and pregnancy are complex processes and we suggest that maternal-neonatal associations are the result of a combination of multiple obstetric tradeoffs.

摘要

目的

本研究旨在分析母亲身体尺寸、新生儿尺寸与妊娠变量之间的相关性。

方法

我们的样本包括131对母婴。我们使用计算机断层扫描骨盆测量法研究了五个新生儿特征(胎龄、出生体重、头围、枕下前囟径和腹围)、三个母亲特征(身高、体重指数和子宫高度)以及三个骨盆变量(对角径、棘间径和耻骨下角)之间的相关性。

结果

我们发现五个新生儿特征之间存在显著的相互关联。体重指数与新生儿特征无关,而母亲身高与出生体重、枕下前囟径和腹围相关。在多元回归模型中,胎龄与出生体重、头围和腹围相关。在新生儿与骨盆测量的相关性中,对角径与枕下前囟径略有相关,但棘间径和耻骨下角与新生儿特征无关。子宫高度可预测所有新生儿变量,但与胎龄无关。

讨论

我们的结果表明,胎儿生长受母亲表型而非外部生态因素的影响。入口尺寸与枕下前囟径的关联反映了新生儿大脑与母亲骨盆尺寸之间的紧密契合,这种适应性可降低头盆不称的风险,而中骨盆和出口处缺乏紧密契合可能是由于骨盆松弛的影响。子宫扩张不是分娩发动的唯一机制。分娩和妊娠是复杂的过程,我们认为母婴关联是多种产科权衡的结果。

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