Gong Xiaoli, Wu Tianchen, Wang Xiaoli, Zhang Lizhen, You Yiping, Wei Hongwei, Zuo Xifang, Zhou Ying, Xing Xinli, Meng Zhaoyan, Lyu Qi, Liu Zhaodong, Zhang Jian, Hu Liyan, Li Junnan, Li Li, Chen Chulin, Liu Chunyan, Sun Guoqiang, Liu Aiju, Chen Jingsi, Lyu Yuan, Wei Yuan, Zhao Yangyu
Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Beijing 100191, China.
Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, China.
Matern Fetal Med. 2021 Sep 15;5(1):16-26. doi: 10.1097/FM9.0000000000000129. eCollection 2023 Jan.
To build a reference fetal growth chart for the Chinese population based on fetal ultrasound measurements.
This was a multicenter, population-based retrospective cohort study. Longitudinal ultrasound measurement data were collected from 24 hospitals in 18 provinces of China from 1 September through 31 October of 2019. The estimated fetal weight (EFW) was calculated based on head circumference, abdominal circumference, and femur length using Hadlock formula 3. Fetal growth curves were estimated using a two-level linear regression model with cubic splines. All participants were divided into two groups: the northern group ( = 5829) and the southern group ( = 3246) based on the geographical division of China and male fetus group ( = 4775) and female fetus group ( = 4300) based on fetal gender. The EFW was compared by fetal gender and geographical group. All statistical models were adjusted for maternal sociodemographic characteristics.
A total of 9075 participants with 31,700 ultrasound measurement records were included in this study. Male fetuses demonstrated significantly larger EFW compared to female ones starting at 16 weeks of gestation and extending to delivery (global test 0.01). The overall geographic difference in EFW was significant (global test = 0.03), and week-specific comparisons showed that the northern group had a greater EFW starting at 15 weeks of gestation and extending to 29 weeks of gestation, although this difference did not extend to the time of delivery. The -score of EFW confirmed that our Chinese fetal growth charts differed from previously published standards.
This study provides EFW and ultrasound biometric reference measurements for Chinese fetuses and reveals differences from other fetal growth charts. The chart is worth promoting in more regions of China but should be tested prudently before use.
基于胎儿超声测量结果构建中国人群的参考胎儿生长曲线。
这是一项多中心、基于人群的回顾性队列研究。于2019年9月1日至10月31日收集了中国18个省份24家医院的纵向超声测量数据。采用哈德洛克公式3，根据头围、腹围和股骨长度计算估计胎儿体重（EFW）。使用具有三次样条的二级线性回归模型估计胎儿生长曲线。根据中国的地理划分，将所有参与者分为北方组（n = 5829）和南方组（n = 3246）；根据胎儿性别，分为男胎组（n = 4775）和女胎组（n = 4300）。比较不同胎儿性别组和地理组的EFW。所有统计模型均对母亲的社会人口学特征进行了校正。
本研究共纳入9075名参与者，有31700条超声测量记录。从妊娠16周开始直至分娩，男胎的EFW显著大于女胎（整体检验P<0.01）。EFW的总体地理差异显著（整体检验P = 0.03），特定孕周的比较显示，北方组从妊娠15周开始直至妊娠29周EFW更大，不过这种差异并未持续到分娩时。EFW的Z评分证实，我们的中国胎儿生长曲线与先前公布的标准不同。
本研究提供了中国胎儿的EFW和超声生物测量参考值，并揭示了与其他胎儿生长曲线的差异。该生长曲线值得在中国更多地区推广，但使用前应谨慎测试。
