目的 探讨并比较早发型和晚发型胎儿生长受限(fetal-growth-restriction,FGR)相关情况。方法 回顾性分析2012-04至2016-03陆军总医院妇产科收治的161例FGR的临床资料,按首次诊断FGR的孕周,分为早发型组、晚发型组,分析两组的主要因素、围生儿结局。结果 早发型组中妊娠期高血压疾病、脐血流异常的发生率分别为29.6%、27.7%,明显高于晚发型组(13.1%、14.0%),差异均有统计学意义(P<0. 05);早发型组中1 min新生儿评分(9.25±1.34)分、新生儿体重(2106±634)g明显低于晚发型组[(9.74±0.72)分、(2418±454) g],差异均有统计学意义(P<0. 05)。早发型组围生儿死亡率为13.7%明显高于晚发型组(0.7%),差异有统计学意义(P<0.05)。结论 早发型FGR具有高合并症的特点,新生儿结局较差,因此应定期产检,及时发现、治疗合并症,改善新生儿的预后。
Abstract
Objective To compare early-onset fetal-growth-restriction(FGR) with late-onset FGR.Methods 161 cases of FGR were retrospectively analyzed, who had been treated at the Army General Hospital between April 2012 and March 2016. According to the first diagnosed pregnancy weeks of FGR, FGR was divided into early-onset group and late-onset group. The main factors and perinatal outcome were analyzed.Results The incidence of gestational hypertension and abnormal vasa umbilicalis among the early-onset were 29.6% and 27.7% respectively, which were significantly higher than that of the late-onset (13.1%, 14.0%). The difference was of statistical significance(P<0.05). 1 min Apgar score (9.25±1.34) and neonatal weight score (2106±635.8) g in the early-onset group were obviously lower than in the late-onset group,(9.74±0.72)and (2418±453.5)g, respectively. The difference of the two scores was of statistical significance(P<0.05). The death rate of perinatal infants in the early-onset group was 13.7%, much higher than that of the late-onset group (0.7%), and the difference was of statistical significance(P<0.05).Conclusions Early-onset FGR is characterized by high complications that lead to poor outcomes. Regular prenatal checkups and punctual treatment of complications can improve the prognosis of the newborn.
关键词
胎儿生长受限 /
相关因素 /
围生儿结局
Key words
fetal growth restriction /
correlative factors /
neonatal outcome
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] 乔 娟, 漆洪波. 胎儿生长受限:更新的认识[J]. 中华围产医学杂志, 2015, 18(6): 418-420.
[2] Oros D, Figueras F, Cruz-Martinez R, et al. Longitudinal changes in uterine, umbilical and fetal cerebral Doppler indices in late-onset small-for-gestational age fetuses [J]. Ultrasound Obstet Gynecol,2011, 37(2):191-195.
[3] Baschat A A. Neurodevelopment after fetal growth restriction [J]. Fetal Diagn Ther, 2014, 36(2): 136-142.
[4] Savchev S, Figueras F, Sanz-Cortes M, et al. Evaluation of an optimal gestational age cut-off for the definition of early- and late-onset fetal growth restriction [J]. Fetal Diagn Ther, 2013, 36(2): 913-919.
[5] Figueras F, Gratacós E. Update on the diagnosis and classification of fetal growth restriction and proposal of a stage-based management protocol [J]. J Clin Microbiol, 2014, 30(11): 2951-2959.
[6] Tower C, Baker P. The genetics of fetal growth restriction: implications for management [J]. Rev Gynaecol Perinat Pract, 2006, 6(1-2):99-105.
[7] Tobi E W, Heijmans B T, Kremer D, et al. DNA methylation of IGF2, GNASAS, INSIGF and LEP and being born small for gestational age [J]. Epigenetics, 2011, 6(2): 171-176.
[8] Crovetto F, Crispi F, Scazzocchio E, et al. Performance of first trimester integrated screening for early and late small for gestational age newborns [J]. Ultrasound Obstet Gynecol, 2013, 43(1):34-40.
[9] 肖 静, 朱付凡. 140 例胎儿生长受限孕周及相关因素分析[J].实用妇产科杂志, 2011, 27(7) : 539-541.
[10] 刘艳鸽, 杨秀丽. 肝素治疗胎儿生长受限27例临床研究[J]. 中国现代应用药学, 2006(S1): 671-673.
[11] Alfirevic Z, Stampalija T, Gyte G M, et al. Fetal and umbilical Doppler ultrasound in high-risk pregnancies [J]. Cochrane Database Syst Rev,2012, 11(1): 7529-7535.
[12] 陈 雪,应 豪, 杨慧琳. 胎儿宫内生长受限管理的研究进展[J]. 现代妇产科进展, 2015,34(2):153-156.
[13] McCowan L M, Pryor J, Harding J E. Perinatal predictors of neurodevelopmental outcome in small-for-gestational-age children at 18 months of age [J]. Am J Obstet Gynecol, 2002, 186(186):1069-1075.
[14] Chia C C,Huang S C.Overview of fetal growth retardation/restriction [J].Taiwan J Obstet Gyne,2014,53(3):435-440.
[15] 罗晓芳, 漆洪波. 胎儿生长受限的胎盘因素及其临床诊治[J].中国实用妇科与产科杂志, 2016,32(4):298-302.
PDF(560 KB)
