Lubrano Chiara, Taricco Emanuela, Coco Chiara, Di Domenico Fiorenza, Mandò Chiara, Cetin Irene
Department of Woman Mother and Neonate 'V. Buzzi' Children Hospital, ASST Fatebenefratelli Sacco, 20154 Milan, Italy.
Department of Biomedical and Clinical Sciences, University of Milan, 20157 Milan, Italy.
J Clin Med. 2022 May 12;11(10):2729. doi: 10.3390/jcm11102729.
Alterations in intrauterine fetal growth increase the risk of adverse perinatal and neonatal outcomes. In this retrospective study, we analyzed data of 906 pregnancies collected in our maternal fetal medicine center, with different patterns of growth: 655 AGA (Appropriate for Gestational Age), 62 SGA (Small for Gestational Age: fetuses born with a weight less than 10° centile, not diagnosed before delivery), 189 FGR (Fetal Growth Restriction, classified in early and late according to gestational week at diagnosis). For each group, we compared maternal characteristics, gestational age at delivery, and perinatal and neonatal outcomes. Risk factors for fetal growth alterations were advanced age, being primiparous, and a lower pregestational BMI. FGR fetuses were born at earlier gestational ages (32 [IQR 29-38] early-FGR and 38 [IQR 36-39] late-FGR), with blood gas values comparable to the AGA group but worse neonatal outcomes related to prematurity. Unexpected SGA fetuses born by vaginal delivery, managed as AGA, were more hyperlactacidemic (4.4 [IQR 2.7-5.5]) and hypoxemic (-5.0 [IQR -7.1-2.8]) at birth than both AGA and FGR. However, neonatal outcomes (accesses and days of hospitalization in NICU) were better than FGR, likely due to gestational age and birthweight similar to AGA.
宫内胎儿生长的改变会增加围产期和新生儿不良结局的风险。在这项回顾性研究中，我们分析了在我们的母胎医学中心收集的906例妊娠的数据，这些妊娠具有不同的生长模式：655例适于胎龄（AGA），62例小于胎龄（SGA：出生体重低于第10百分位数且在分娩前未诊断出的胎儿），189例胎儿生长受限（FGR，根据诊断时的孕周分为早期和晚期）。对于每组，我们比较了母亲特征、分娩时的孕周以及围产期和新生儿结局。胎儿生长改变的危险因素为高龄、初产和孕前体重指数较低。FGR胎儿出生时孕周较早（早期FGR为32周[四分位间距29 - 38周]，晚期FGR为38周[四分位间距36 - 39周]），血气值与AGA组相当，但与早产相关的新生儿结局较差。经阴道分娩的意外SGA胎儿按AGA处理，出生时比AGA和FGR都更易出现高乳酸血症（4.4[四分位间距2.7 - 5.5]）和低氧血症（-5.0[四分位间距-7.1 - 2.8]）。然而，其新生儿结局（入住新生儿重症监护病房和住院天数）比FGR更好，这可能是由于其孕周和出生体重与AGA相似。
