晚发型胎儿生长受限的相关因素对围产儿结局的影响
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南京医科大学科技发展基金重点项目(2013NJMU142)


Effects of factors related to late-onset fetal growth restriction on perinatal outcomes
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    摘要:

    目的:探讨晚发型胎儿生长受限(fetal growth restriction,FGR)的相关因素及其对围产儿结局的影响-方法:收集2012年5月~2013年10月在南京医科大学附属南京妇幼保健院分娩的140例晚发型FGR的孕妇及新生儿的临床资料,分别按有无妊娠并发症-分娩孕周(32~33+6周为Ⅰ组,34~36+6周为Ⅱ组,37~40+4周为Ⅲ组)-分娩方式分组,比较各组间新生儿的体格发育及主要疾病患病率-结果:有妊娠并发症组晚发型FGR新生儿的出生体重-身长均明显小于无并发症组;新生儿败血症-新生儿肺炎-新生儿呼吸窘迫综合征(ARDS)的患病率明显高于无并发症组-新生儿生长发育各指标与总孕周的回归系数均小于Ⅱ组,与Ⅰ组-Ⅲ组无回归关系;Ⅰ组-Ⅱ组在新生儿败血症-新生儿肺炎及ARDS的患病率均高于Ⅲ组-足月儿的出生体重-身长在剖宫产组明显小于阴道分娩组,其他在分娩方式间比较均无统计学意义-结论:晚发型FGR的胎儿在孕34~36+6周生长发育较快,其足月儿的新生儿主要疾病患病率相对较低,因此孕期可在积极治疗-密切监护的前提下,尽可能延长孕周至37周;其围产儿的结局相对较好,可以在严密监护下阴道试产-

    Abstract:

    Objective:To investigate factors associated with late-onset fetal growth restriction (FGR) and their impacts on perinatal outcomes. Methods:Maternal and neonatal data from 140 cases of late-onset FGR were collected from Nanjing Maternity and Child Health Care Hospital affiliated to Nanjing Medical University from May 2012 to October 2013. All cases were divided into several groups according to pregnancy complications,gestational weeks (32 to 33+6 weeks for group Ⅰ,34 to 36+6 weeks for group II,37 to 40+4 weeks for group Ⅲ) and delivery modes. Neonatal physical development and morbidities of common diseases were compared among groups. Results:The birth weight and body length of newborns of the group with pregnancy complications were significantly lower than those without pregnancy complications. The morbidities of neonatal septicemia,neonatal pneumonia and acute respiratory distress syndrome (ARDS) of the group with pregnancy complications were significantly higher than those without pregnancy complications. The regression coefficient between neonatal physical development indexes and total gestational weeks was all less than group Ⅱ,and there were no regression relation between neonatal physical development indexes and groupⅠand Ⅲ. The morbidities of neonatal septicemia,neonatal pneumonia and ARDS of groupⅠandⅡwere significantly higher than those of group Ⅲ. The birth weight and body length of term newborns of the cesarean group were significantly lower than those of the vaginal delivery group. No other significant differences were observed between the two groups. Conclusion:The late-onset FGR fetuses display rapid growth and development in pregnancy 34 to 36+6 weeks and the common diseases morbidities of term newborns are relatively low. Therefore,gestational weeks could be extended to 37 weeks if only intensive therapy and close monitoring are available. The perinatal outcomes of late-onset FGR were relatively good;therefore,vaginal delivery with intensive care could be recommended.

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苗治晶,吴 虹,丁虹娟.晚发型胎儿生长受限的相关因素对围产儿结局的影响[J].南京医科大学学报(自然科学版),2014,(8):1097-1101

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  • 收稿日期:2014-02-06
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  • 在线发布日期: 2014-08-03
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