Goto Minako, Seo Kohei, Okuyama Ayumi, Ichizuka Kiyotake
Department of Obstetrics and Gynecology, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan.
Department of Obstetrics and Gynecology, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan.
Placenta. 2025 Jan;159:32-38. doi: 10.1016/j.placenta.2024.11.013. Epub 2024 Nov 25.
We evaluated the impact of absent end-diastolic flow in the umbilical artery (UA-AEDF) in severe small for gestational age (SGA) cases.
This retrospective cohort study focused on fetuses with severe SGA (defined as birth weight ≤2.5 SD). Clinical measurements and neonatal outcomes were compared between the UA-AEDF and non-UA-AEDF groups.
Fifty-four patients were categorized into UA-AEDF (15 patients) and non-UA-AEDF (39 patients) groups. Regarding neonatal short-term prognosis, the UA-AEDF group showed higher rates of respiratory distress syndrome (RDS), late circulatory dysfunction, late metabolic acidosis, and retinopathy of prematurity (ROP) requiring laser treatment than the non-UA-AEDF group. However, within 32 weeks of gestation, the complication rates between the two groups were not significantly different. In the 32 weeks before delivery, the overall developmental quotient (DQ) scores of children in the UA-AEDF group were lower than those in the non-UAAEDF group. Specifically, within the UA-AEDF group, the mean DQ scores at 1.5 years of corrected age was significantly lower prior to 32 weeks of gestation than in the other groups.
This study demonstrated that UA-AEDF in severely SGA infants before 32 weeks of gestation may be associated with poor long-term prognosis, comparable to preterm infants. Conversely, in non-UA-AEDF cases, the frequency of poor long-term prognosis, involving DQ, remained consistent before and after 32 weeks of gestation. This study highlights the potential significance of UA-AEDF in predicting neurodevelopmental outcomes in severe SGA infants; thus, incorporating UA Doppler findings into clinical protocols for severe SGA cases is helpful.
我们评估了脐动脉舒张末期血流缺失（UA-AEDF）对严重小于胎龄儿（SGA）病例的影响。
这项回顾性队列研究聚焦于患有严重SGA（定义为出生体重≤2.5标准差）的胎儿。比较了UA-AEDF组和非UA-AEDF组的临床测量指标和新生儿结局。
54例患者被分为UA-AEDF组（15例患者）和非UA-AEDF组（39例患者）。关于新生儿短期预后，UA-AEDF组的呼吸窘迫综合征（RDS）、晚期循环功能障碍、晚期代谢性酸中毒以及需要激光治疗的早产儿视网膜病变（ROP）发生率高于非UA-AEDF组。然而，在妊娠32周内，两组的并发症发生率无显著差异。在分娩前的32周内，UA-AEDF组儿童的总体发育商（DQ）得分低于非UA-AEDF组。具体而言，在UA-AEDF组中，矫正年龄1.5岁时的平均DQ得分在妊娠32周前显著低于其他组。
本研究表明，妊娠32周前严重SGA婴儿的UA-AEDF可能与不良长期预后相关，与早产儿相当。相反，在非UA-AEDF病例中，涉及DQ的不良长期预后频率在妊娠32周前后保持一致。本研究强调了UA-AEDF在预测严重SGA婴儿神经发育结局方面的潜在意义；因此，将脐动脉多普勒检查结果纳入严重SGA病例的临床方案中是有帮助的。
