妊娠合并症对晚发型胎儿生长受限的影响
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南京医科大学科技发展基金重点项目(2013NJMU142)


The influence of pregnancy complications on late onset fetal growth restriction
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    目的:探讨妊娠合并症对晚发型胎儿生长受限(fetal growth restriction,FGR)的影响-方法:收集2013年本院130例诊断胎儿生长受限病例并随机抽取130例正常对照病例的临床资料,对两组的妊娠高血压疾病-贫血-甲状腺功能减退症-妊娠期糖尿病(GDM)-妊娠期肝内胆汁淤积症(ICP)的发生率进行比较分析,分别检测两组红细胞叶酸值并进行比较分析-根据对症处理及胎儿治疗情况,进一步将生长受限的胎儿分为干预组和非干预组两个亚组,比较两组新生儿出生体重达到相应孕周标准体重的比率-早产-胎儿窘迫-新生儿窒息-新生儿肺炎的发病率之间的差异-结果:FGR组妊娠高血压疾病-贫血-妊娠期甲状腺功能减退症的发生率明显高于对照组(P < 0.05),GDM-ICP的发生率无显著差异(P > 0.05)-FGR组红细胞叶酸值明显低于非FGR对照组,差异有统计学意义(P < 0.05)-干预组新生儿出生体重达到相应孕周标准体重的比率明显高于非干预组(P < 0.05),干预组早产-胎儿窘迫-新生儿窒息-新生儿肺炎的发病率明显低于非干预组(P < 0.05)-结论:妊娠期高血压疾病是引起胎儿生长受限的主要因素,同时贫血-叶酸缺乏-妊娠期甲状腺功能减退症等也直接影响胎儿的生长发育,根据病因给予干预性治疗可以明显改善妊娠结局-

    Abstract:

    Objective:To discuss the influence of pregnancy complications on late onset fetal growth restriction (FGR). Methods:A total of 130 patients with FGR and 130 randomly selected normal pregnant women were collected from Nanjing Maternity and Child Health Care Hospital during 2013. The incidences of hypertensive disorder complicating pregnancy,anemia,gestational thyroid hypofunction,gestational diabetes mellitus (GDM) and intrahepatic cholestasis of pregnancy (ICP) in the two groups were compared. Meanwhile,folates of red blood cell in the two groups were also determined for comparative analysis. According to the different symptomatic treatment and nutrition status in FGR fetuses,130 cases of FGR were divided into two subgroups,48 cases in the no-intervention group and 82 cases in the intervention group. The rate reaching the standard of neonatal body weight,premature birth,fetal distress,and neonatal asphyxia,neonatal pneumonia between the two subgroups was compared. Results:Compared with the control group,the occurrence rates of hypertensive disorder complicating pregnancy,anemia and gestational thyroid hypofunction were significantly higher in the FGR group (P < 0.05). However,the difference in the occurrence rates of GDM and ICP between the two groups was not significant (P > 0.05). The level of red blood cell folate in the FGR group was significantly lower than that in the control group (P < 0.05). The rate reaching the standard of normal neonatal body weight in the intervention group was significantly increased compared to that in the none-intervention group (P < 0.05). The incidences of premature birth,fetal distress,neonatal asphyxia and neonatal pneumonia in the intervention group were also lower than those in the none-intervention group (P < 0.05). Conclusion:Hypertensive disorder complicating pregnancy is the most important factor causing fetal growth restriction. Meanwhile, anemia, lack of folic acid and gestational thyroid hypofunction and some other factors also directly affect the growth and development of the fetus. Interventional treatment can significantly improve pregnancy outcome according to etiology.

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邰 雯,吴 虹,丁虹娟.妊娠合并症对晚发型胎儿生长受限的影响[J].南京医科大学学报(自然科学版),2014,(7):968-972

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  • 收稿日期:2014-02-18
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  • 在线发布日期: 2014-07-05
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