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胎儿脐静脉标准化血流量在预测孕晚期体重增加中的价值:一项前瞻性病例队列研究。

Value of foetal umbilical vein standardised blood flow volume in predicting weight gain in the third trimester: a prospective case-cohort study.

作者信息

Fang Qian, Shi Yihao, Zhang Chao, Cai Ying, Yuan Cuili, Yang Jiaxiang, He Guannan

机构信息

Department of Ultrasound, LongQuanYi District of Chengdu Maternity and Child Health Care Hospital, Chengdu, China.

Department of Statistics, LongQuanYi District of Chengdu Maternity and Child Health Care Hospital, Chengdu, China.

出版信息

Front Pediatr. 2024 Jul 16;12:1376774. doi: 10.3389/fped.2024.1376774. eCollection 2024.

Abstract

OBJECTIVE

This study aims to establish a prediction model of foetal umbilical vein standardised blood flow volume (sQuv) on estimated foetal weight (EFW) in the third trimester.

METHODS

A case-cohort study involving 200 eligible normal foetuses was conducted at the Ultrasound Department of Longquanyi District of Maternity and Child Healthcare Hospital between June 1, 2020 and December 31, 2021. Ultrasound measurements were taken at two separate intervals to assess EFW and the rate of EFW (rEFW) [first: between 28 w and 33 w6d of gestational age (GA); second: after 4-6 weeks]. Umbilical vein blood flow volume (Quv) and sQuv (normalised with EFW) were calculated only during the initial measurement. Using general linear regression, a prediction model for EFW based on GA and sQuv was developed, with the gestational week employed as a calibration scalar and validated using linear regression cross-validation.

RESULTS

In the third trimester, EFW exhibited significant correlations with GA, abdominal circumference (AC), head circumference (HC) and Quv (all  > 0.6,  < 0.001). Furthermore, the rEFW showed significant correlations with Quv and sQuv (all  > 0.6,  < 0.001). A linear regression equation was established using a general linear regression model: rEFW = 0.32689 × sQuv. Additionally, a foetal weight prediction model (EFW = -2,554.6770 + 0.9655 × sQuv + 129.6916 × GA) was established using sQuv. The above two formulas were cross-validated by intra-group linear regression and proved to be of good efficacy.

CONCLUSIONS

In the third trimester, EFW displayed significant correlations with GA, AC, HC and Quv. Additionally, the rEFW exhibited significant correlations with Quv and sQuv. The sQuv during the third trimester has predictive value for foetal weight, serving as an early warning indicator.

摘要

目的

本研究旨在建立孕晚期胎儿脐静脉标准化血流量(sQuv)对估计胎儿体重(EFW)的预测模型。

方法

2020年6月1日至2021年12月31日期间,在龙泉驿区妇幼保健院超声科对200例符合条件的正常胎儿进行了病例队列研究。在两个不同时间点进行超声测量,以评估EFW和EFW增长率(rEFW)[第一次:孕龄(GA)在28周和33周6天之间;第二次:4-6周后]。仅在初次测量时计算脐静脉血流量(Quv)和sQuv(用EFW标准化)。使用一般线性回归,建立了基于GA和sQuv的EFW预测模型,将孕周用作校准标量,并使用线性回归交叉验证进行验证。

结果

在孕晚期,EFW与GA、腹围(AC)、头围(HC)和Quv均呈显著相关性(均>0.6,<0.001)。此外,rEFW与Quv和sQuv均呈显著相关性(均>0.6,<0.001)。使用一般线性回归模型建立线性回归方程:rEFW = 0.32689×sQuv。此外,使用sQuv建立了胎儿体重预测模型(EFW = -2554.6770 + 0.9655×sQuv + 129.6916×GA)。上述两个公式通过组内线性回归进行交叉验证,证明疗效良好。

结论

在孕晚期,EFW与GA、AC、HC和Quv均呈显著相关性。此外,rEFW与Quv和sQuv均呈显著相关性。孕晚期的sQuv对胎儿体重具有预测价值,可作为早期预警指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/be6a/11289770/af75485cfb97/fped-12-1376774-g001.jpg

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