Hong Jee-Youn, Kim Jin-Ha, Kim Seo-Yeon, Sung Ji-Hee, Choi Suk-Joo, Oh Soo-Young, Roh Cheong-Rae
Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.
Department of Obstetrics and Gynecology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea.
J Clin Med. 2021 May 29;10(11):2413. doi: 10.3390/jcm10112413.
This study aimed to investigate whether a difference in gestational age according to biparietal diameter (BPD) and abdominal circumference (AC) could be a clinically useful predictor of placental abruption during the intrapartum period. This retrospective cohort study was based on singletons who were delivered after 32 + 0 weeks between July 2015 and July 2020. We only included cases with at least two antepartum sonographies available within 4 weeks of delivery ( = 2790). We divided the study population into two groups according to the presence or absence of placental abruption and compared the clinical variables. The incidence of placental abruption was 2.0% (56/2790) and was associated with an older maternal age, a higher rate of preeclampsia, and being small for the gestational age. A difference of >2 weeks in gestational age according to BPD and AC occurred at a higher rate in the placental abruption group compared to the no abruption group (>2 weeks, 21.4% (12/56) vs. 7.5% (205/2734), < 0.001; >3 weeks, 12.5% (7/56) vs. 2.0% (56/2734), < 0.001). Logistic regression analysis revealed that the differences of >2 weeks and >3 weeks were both independent risk factors for placental abruption (odds ratio (OR) (95% confidence interval), 2.289 (1.140-4.600) and 3.918 (1.517-9.771), respectively) after adjusting for maternal age, preeclampsia, and small for gestational age births. We identified that a difference in gestational age of >2 weeks between BPD and AC could be an independent predictor of placental abruption.
本研究旨在探讨根据双顶径(BPD)和腹围(AC)计算的孕周差异是否可作为产时胎盘早剥的临床有用预测指标。这项回顾性队列研究基于2015年7月至2020年7月期间孕32 + 0周后分娩的单胎妊娠。我们仅纳入了在分娩前4周内至少有两次产前超声检查的病例(n = 2790)。根据是否发生胎盘早剥将研究人群分为两组,并比较临床变量。胎盘早剥的发生率为2.0%(56/2790),与母亲年龄较大、子痫前期发生率较高以及小于孕周有关。与无胎盘早剥组相比,胎盘早剥组中根据BPD和AC计算的孕周差异>2周的发生率更高(>2周,21.4%(12/56)对7.5%(205/2734),P < 0.001;>3周,12.5%(7/56)对2.0%(56/2734),P < 0.001)。逻辑回归分析显示,在调整母亲年龄、子痫前期和小于孕周出生因素后,>2周和>3周的差异均为胎盘早剥的独立危险因素(优势比(OR)(95%置信区间)分别为2.289(1.140 - 4.600)和3.918(1.517 - 9.771))。我们发现,BPD和AC之间孕周差异>2周可作为胎盘早剥的独立预测指标。