Kieler H, Hellberg D, Nilsson S, Waldenström U, Axelsson O
Department of Obstetrics and Gynecology, Uppsala University, Sweden.
Ultrasound Obstet Gynecol. 1998 Feb;11(2):104-9. doi: 10.1046/j.1469-0705.1998.11020104.x.
Our objective was to characterize and evaluate pregnancy outcome in women who declined participation in a trial on ultrasound screening in the second trimester. Between 1985 and 1987, 8768 women were recruited for a trial on ultrasound screening. By randomization, 4997 women were assigned to either a screening or a non-screening group. Of the 1414 excluded women, data were retrieved from 1211 (86%). Participation was declined by 526 of these 1211 women, either because of anxiety regarding harmful effects of ultrasound or because they could see no benefits of ultrasound scanning. Non-participants and participants were compared. The non-participants were older, had a higher birth/pregnancy ratio, were less often smokers, and had fewer ultrasound examinations than the participants. There was a longer mean pregnancy length, an increased number of post-term deliveries, more suspicions of small-for-gestational-age fetuses and later detections of multiple pregnancies among non-participants as compared with the screening group. No differences in neonatal morbidity were found except for a greater number of mild respiratory disorders in the non-participant group. The non-participant women were more obstetrically experienced and showed indications of a healthier lifestyle in comparison with participants. The differences found in pregnancy outcome could be explained by the ultrasound screening procedure. There were no major differences in neonatal morbidity between the groups.
我们的目标是对拒绝参与一项关于孕中期超声筛查试验的女性的妊娠结局进行特征描述和评估。1985年至1987年期间，8768名女性被招募参与一项超声筛查试验。通过随机分组，4997名女性被分配到筛查组或非筛查组。在1414名被排除的女性中，从1211名（86%）女性那里获取了数据。这1211名女性中有526名拒绝参与，原因要么是担心超声的有害影响，要么是认为超声扫描没有益处。对非参与者和参与者进行了比较。与参与者相比，非参与者年龄更大，生育/妊娠比例更高，吸烟的情况较少，接受超声检查的次数也更少。与筛查组相比，非参与者的平均妊娠时长更长，过期产的数量增加，对小于胎龄儿的怀疑更多，多胎妊娠的发现更晚。除了非参与者组中轻度呼吸系统疾病的数量更多外，未发现新生儿发病率存在差异。与参与者相比，非参与者女性的产科经验更丰富，且显示出生活方式更健康的迹象。妊娠结局中发现的差异可以通过超声筛查程序来解释。两组之间新生儿发病率没有重大差异。
