Hata T, Deter R L, Hill R M
Department of Obstetrics and Gynecology, Baylor College of Medicine Houston, Texas.
J Clin Ultrasound. 1993 Sep;21(7):415-21. doi: 10.1002/jcu.1870210703.
A new growth classification system for triplets based on individual growth curve standards provides new information on the growth status of triplets at birth. OBJECTIVES. The objectives of this study were to characterize growth outcome at birth in triplet pregnancies using Individualized Growth Assessment methods, and to compare these results to conventional methods of growth outcome evaluation. STUDY DESIGN. Rossavik growth models derived from second-trimester ultrasound measurements were used to predict the birth characteristics of 21 triplet neonates. Actual measurements of weight, head, abdominal, and thigh circumferences at birth were compared to population standards and to predicted values, the latter by calculation of Growth Potential Realization Index (GPRI) values. GPRI values were calculated using singleton (measurement procedure correction) and triplet (measurement procedure correction+decreased soft tissue deposition) correction factors (SCF, TCF). Neonatal Growth Assessment Scores (NGAS) were calculated using both sets of GPRI values. RESULTS. Three types of triplet neonates were identified. Group I (33.3%) were normal with both types of NGAS values, had very few abnormal GPRI values or anatomic measurements, and were all appropriate for gestational age. Group III (14.3%) were abnormal with both types of NGAS values, most GPRI values were abnormal, and all were small for gestational age. Group II (52.4%) had abnormal NGAS values when calculated from GPRI values determined with SCF and normal NGAS values when calculated from GPRI values determined with TCF. All but one was AGA. Almost all GPRIWT and GPRIThC values were abnormal using SCF and normal using TCF. CONCLUSION. Although growth outcome in triplet neonates can be normal (Group I) or intrauterine growth retarded (Group III), the majority are in an intermediate group (Group II) characterized by a decrease in soft tissue mass, which may or may not be pathological.
一种基于个体生长曲线标准的三胞胎新生长分类系统提供了三胞胎出生时生长状况的新信息。目的。本研究的目的是使用个体化生长评估方法来描述三胞胎妊娠出生时的生长结局，并将这些结果与传统的生长结局评估方法进行比较。研究设计。从孕中期超声测量得出的Rossavik生长模型用于预测21例三胞胎新生儿的出生特征。将出生时体重、头围、腹围和大腿围的实际测量值与人群标准以及预测值进行比较，后者通过计算生长潜能实现指数（GPRI）值获得。GPRI值使用单胎（测量程序校正）和三胞胎（测量程序校正+软组织沉积减少）校正因子（SCF、TCF）进行计算。使用两组GPRI值计算新生儿生长评估分数（NGAS）。结果。识别出三种类型的三胞胎新生儿。第一组（33.3%）在两种类型的NGAS值方面均正常，异常的GPRI值或解剖测量值很少，且均为适于胎龄儿。第三组（14.3%）在两种类型的NGAS值方面均异常，大多数GPRI值异常，且均为小于胎龄儿。第二组（52.4%）在用SCF确定的GPRI值计算时NGAS值异常，在用TCF确定的GPRI值计算时NGAS值正常。除1例之外均为适于胎龄儿。使用SCF时几乎所有GPRIWT和GPRIThC值均异常，使用TCF时则正常。结论。虽然三胞胎新生儿的生长结局可以是正常的（第一组）或宫内生长受限（第三组），但大多数属于中间组（第二组），其特征是软组织量减少，这可能是病理性的，也可能不是。
