Evans S, Newnham J, MacDonald W, Hall C
Foundation for Women's and Infants' Health, University Department of Obstetrics and Gynaecology, King Edward Memorial Hospital for Women, Subiaco, Australia.
Early Hum Dev. 1996 Jul 19;45(3):203-14. doi: 10.1016/0378-3782(96)01728-8.
The objective of this study was to evaluate and characterise by study of newborn biometry a possible effect on birthweight which we observed previously in a randomised controlled trial of multiple prenatal ultrasound examinations. A total of 2743 women with single pregnancies had been allocated at random to either a protocol of ultrasound imaging and continuous wave Doppler studies at 18, 24, 28, 34 and 38 weeks gestation (intensive group), or to a protocol of a single imaging examination at 18 weeks and further imaging scans only as clinically indicated (regular group). When compared with those in the regular group, and adjusted for other confounding variables, normally formed babies of term gestational age in the intensive group tended to be shorter when measured at birth (P = 0.123) and on day 2-3 of age (P = 0.068). There were statistically insignificant reductions in the circumferences of the chest, abdomen and mid-arm; and in the skinfold thicknesses of the triceps, parascapular and subscapular regions. Principal component analysis showed a trend for a reduction for the skeletal component (P = 0.085) but not for the soft tissue component (P = 0.332). Comparison of the neonatal biometry in the two groups is not conclusive, but the differential effects on the various growth parameters suggest that if multiple scans do indeed restrict fetal growth, the mechanism is more likely to be an effect on bone growth rather than a reduction in nutrient supply from the placenta.
本研究的目的是通过对新生儿生物测量学的研究,评估并描述我们之前在一项关于多次产前超声检查的随机对照试验中观察到的对出生体重可能产生的影响。共有2743名单胎妊娠妇女被随机分配到以下两种方案之一:在妊娠18、24、28、34和38周时进行超声成像和连续波多普勒研究的方案(强化组),或在妊娠18周时进行一次成像检查,仅在临床需要时进行进一步成像扫描的方案(常规组)。与常规组相比,并对其他混杂变量进行调整后,强化组中足月正常发育的婴儿在出生时(P = 0.123)和出生后第2 - 3天(P = 0.068)测量时往往较短。胸部、腹部和上臂中部的周长以及肱三头肌、肩胛旁和肩胛下区域的皮褶厚度有统计学上不显著的减小。主成分分析显示骨骼成分有减小趋势(P = 0.085),但软组织成分无此趋势(P = 0.332)。两组新生儿生物测量学的比较尚无定论,但对各种生长参数的不同影响表明,如果多次扫描确实会限制胎儿生长,其机制更可能是对骨骼生长的影响,而不是胎盘营养供应的减少。