Bujorescu Daniela-Loredana, Ratiu Adrian, Citu Cosmin, Gorun Florin, Gorun Oana Maria, Crisan Doru Ciprian, Cozlac Alina-Ramona, Chiorean-Cojocaru Ioana, Tunescu Mihaela, Popa Zoran Laurentiu, Folescu Roxana, Motoc Andrei
Doctoral School, "Victor Babes" University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Square, 300041 Timisoara, Romania.
Department of Obstetrics and Gynecology, "Victor Babes" University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Square, 300041 Timisoara, Romania.
J Pers Med. 2023 Apr 8;13(4):645. doi: 10.3390/jpm13040645.
(1) Background: The main challenge in cases of early onset fetal growth restriction is management (i.e., timing of delivery), trying to determine the optimal balance between the opposing risks of stillbirth and prematurity. The aim of this study is to determine the likelihood of neonatal complications depending on the time of birth based on Doppler parameters in fetuses with early onset fetal growth restriction; (2) Methods: A case-control study of 205 consecutive pregnant women diagnosed with early onset FGR was conducted at the Obstetrics Clinic of the Municipal Emergency Hospital in Timisoara, Romania; The case group included newborns who were delivered at the onset of umbilical arteries absent/reversed end-diastolic flow, and the control included infants delivered at the onset of reversed/absent ductus venosus A-wave. (3) Results: The overall neonatal mortality rate was 2.0%, and there was no significant statistical difference between the two study groups. In infants delivered up to 30 gestational weeks, grades III/IV intraventricular hemorrhage and bronchopulmonary dysplasia were statistically significantly more frequent in the control group. Moreover, univariate binomial logistic regression analysis on fetuses born under 30 gestational weeks shows that those included in the control group are 30 times more likely to develop bronchopulmonary dysplasia and 14 times more likely to develop intraventricular hemorrhage grades III/IV; (4) Conclusions: Infants delivered according to the occurrence of umbilical arteries absent/reversed end-diastolic flow are less likely to develop intraventricular hemorrhage grades III/IV and bronchopulmonary dysplasia.
(1) 背景：早发型胎儿生长受限病例的主要挑战在于管理（即分娩时机），试图在死产和早产这两种相反风险之间确定最佳平衡。本研究的目的是根据早发型胎儿生长受限胎儿的多普勒参数，确定取决于出生时间的新生儿并发症发生可能性；(2) 方法：在罗马尼亚蒂米什瓦拉市急诊医院妇产科对205例连续诊断为早发型胎儿生长受限的孕妇进行了病例对照研究；病例组包括在脐动脉舒张末期血流缺失/反向时分娩的新生儿，对照组包括在静脉导管A波反向/缺失时分娩的婴儿。(3) 结果：总体新生儿死亡率为2.0%，两个研究组之间无显著统计学差异。在孕30周前分娩的婴儿中，对照组的III/IV级脑室内出血和支气管肺发育不良在统计学上明显更常见。此外，对孕30周前出生的胎儿进行单变量二项逻辑回归分析表明，对照组的胎儿发生支气管肺发育不良的可能性高30倍，发生III/IV级脑室内出血的可能性高14倍；(4) 结论：根据脐动脉舒张末期血流缺失/反向情况分娩的婴儿发生III/IV级脑室内出血和支气管肺发育不良的可能性较小。
