Bahia Maria Luiza Rozo, Velarde Guillermo Coca, Silva Fernanda Campos da, Araujo Júnior Edward, Sá Renato Augusto Moreira de
Post-Graduate Program in Medical Science, Fluminense Federal University (UFF), Niterói, Brazil.
Fetal Medicine Unit, Perinatal Rede D'Or São Luiz, Rio de Janeiro, Brazil.
J Matern Fetal Neonatal Med. 2022 Dec;35(25):8666-8672. doi: 10.1080/14767058.2021.1995858. Epub 2021 Oct 26.
To evaluate perinatal outcomes in fetuses with severe late-onset fetal growth restriction.
This was a retrospective and observational cohort study in which pregnant women diagnosed with late-onset fetal growth restriction assisted at perinatal maternity birth from 2010 to 2017 were included. The outcomes were intensive care unit (ICU) admission and perinatal complications, such as neonatal death, intraventricular hemorrhage, periventricular leukomalacia, hypoxic-ischemic encephalopathy, necrotizing enterocolitis, bronchopulmonary dysplasia, and sepsis.
We selected 277 pregnant women, of whom 124 newborns (44.76%) went to the ICU. The chance of a newborn needing ICU decreases by 62, 7, and 9% according to an increase of one gestational week, 1 cm of the abdominal circumference, or 1 cm of the amniotic fluid index, respectively. Oligohydramnios increases the risk of going to the ICU by 2.13 times. The increase in the umbilical artery pulsatility index (PI) Doppler increases the chance of ICU admission by 7.9 times. The normal middle cerebral artery PI Doppler and the normal cerebroplacental ratio reduce the risk of ICU admission.
The estimated fetal weight, abdominal circumference, and amniotic fluid index diagnosed severe late-onset fetal growth restriction. With the decrease in middle cerebral artery PI Doppler, there is a greater probability of admission to the ICU, with the most common complications being intraventricular hemorrhage and necrotizing enterocolitis.
评估重度晚发型胎儿生长受限胎儿的围产期结局。
这是一项回顾性观察队列研究,纳入了2010年至2017年在围产期产科分娩时被诊断为晚发型胎儿生长受限的孕妇。结局指标为重症监护病房(ICU)收治情况及围产期并发症,如新生儿死亡、脑室内出血、脑室周围白质软化、缺氧缺血性脑病、坏死性小肠结肠炎、支气管肺发育不良和败血症。
我们选取了277名孕妇,其中124名新生儿(44.76%)进入了ICU。根据孕周增加1周、腹围增加1 cm或羊水指数增加1 cm,新生儿需要进入ICU的几率分别降低62%、7%和9%。羊水过少使进入ICU的风险增加2.13倍。脐动脉搏动指数(PI)多普勒值升高使进入ICU的几率增加7.9倍。大脑中动脉PI多普勒值正常及脑胎盘比值正常可降低进入ICU的风险。
估计胎儿体重、腹围和羊水指数可诊断重度晚发型胎儿生长受限。随着大脑中动脉PI多普勒值降低,进入ICU的可能性更大,最常见的并发症为脑室内出血和坏死性小肠结肠炎。