孕晚期超声生物测量联合血流动力学指标预测分娩足月小于胎龄儿的效能分析OA
Efficacy of ultrasound biometric measurements combined with hemodynamic indices in late pregnancy for predicting the delivery of full-term small for gestational age infants
目的 探讨孕晚期超声检查胎儿生物测量指标联合多普勒血流动力学指标预测分娩足月小于胎龄儿(SGA)的效能.方法 回顾性分析2023年6月—2024年12月在北京市通州区妇幼保健院分娩足月SGA的80例产妇为病例组,另选取同期(2周内)分娩足月适于胎龄儿(AGA)的80例产妇为对照组.比较2组孕晚期(孕28～32周)胎儿生物测量指标[胎儿双顶径(BPD)、头围(HC)、腹围(AC)和股骨长(FL)]以及多普勒血流动力学指标[脐动脉(UA)和胎儿大脑中动脉(MCA)搏动指数(PI)、阻力指数(RI)].采用受试者工作特征(ROC)曲线分析上述指标对足月SGA的预测效能.结果 病例组与对照组产妇年龄、孕次、产次、分娩方式、分娩孕周、孕期并发症等比较,差异均无统计学意义(P＞0.05);2组新生儿出生体质量的差异有统计学意义(P＜0.01).病例组孕晚期胎儿生物测量指标BPD、HC、AC、FL均低于对照组,差异有统计学意义(P＜0.01);病例组孕晚期UA的PI、RI高于对照组,MCA的PI、RI低于对照组,差异有统计学意义(P＜0.01).孕晚期超声指标联合检测预测分娩足月SGA的曲线下面积(AUC)为0.909,高于BPD、HC、AC、FL、UA-PI、UA-RI、MCA-PI、MCA-RI单独检测0.749、0.755、0.799、0.783、0.828、0.807、0.810、0.799,差异均有统计学意义(P＜0.05).结论 孕晚期超声检查胎儿生物测量指标联合多普勒血流动力学指标可反映胎儿宫内生长状态,预测足月SGA发生的准确性较高.
Objective To investigate the efficacy of fetal biometric measurements combined with Doppler hemodynamic indices in late pregnancy for predicting the delivery of full-term small for gesta-tional age(SGA)infants.Methods A retrospective analysis was conducted in 80 pregnant women who delivered full-term SGA infants in the Maternal and Child Healthcare Hospital of Tongzhou District in Beijing from June 2023 to December 2024(case group),and another 80 pregnant women who de-livered full-term appropriate for gestational age(AGA)infants during the same period(within 2 weeks)were selected as control group.Fetal biometric measurements[biparietal diameter(BPD),head circumference(HC),abdominal circumference(AC),and femoral length(FL)]and Doppler he-modynamic indices[pulsatility index(PI)and resistance index(RI)of the umbilical artery(UA)and fetal middle cerebral artery(MCA)]in late pregnancy(28 to 32 weeks of gestation)were compared be-tween the two groups.The predictive efficacy of these indices for full-term SGA was analyzed using re-ceiver operating characteristic(ROC)curve.Results There were no significant differences in maternal age,gravidity,parity,mode of delivery,gestational age at delivery,and pregnancy complications between the case and control groups(P＞0.05).However,a significant difference was observed in neonatal birth weight between the two groups(P＜0.01).In the case group,fetal biometric meas-urements(BPD,HC,AC,and FL)in late pregnancy were significantly lower than those in the control group(P＜0.01).The PI and RI of the UA in late pregnancy in the case group were signifi-cantly higher than those in the control group,while the PI and RI of the MCA were significantly low-er(P＜0.01).The area under the curve(AUC)for the combined ultrasound indices in predicting the delivery of full-term SGA infants in late pregnancy was 0.909,which was significantly higher than AUC values for individual measurement of BPD(0.749),HC(0.755),AC(0.799),FL(0.783),UA-PI(0.828),UA-RI(0.807),MCA-PI(0.810),or MCA-RI(0.799)(P＜0.05).Conclusion Fetal biometric measurements combined with Doppler hemodynamic indices in late pregnancy can reflect fetal intrauterine growth status and provide high accuracy in predicting the occurrence of full-term SGA.
陈晓春;陈炫嘉;朱毓;杨立
北京市通州区妇幼保健院新生儿科,北京,101101北京市通州区妇幼保健院超声科,北京,101101北京市通州区妇幼保健院超声科,北京,101101北京市通州区妇幼保健院新生儿科,北京,101101
医药卫生
小于胎龄儿适于胎龄儿胎儿生长受限双顶径头围脐动脉大脑中动脉搏动指数阻力指数
small for gestational age infantappropriate for gestational age infantfetal growth restrictionbiparietal diametershead circumferenceumbilical arterymiddle cerebral arterypul-satility indexresistance index
《实用临床医药杂志》 2026 (4)
111-114,4
北京市通州区科技计划项目(KJ2023CX071)
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