羊水过少对小于胎龄儿影响的病例-对照研究

Case-control study on the influence of oligohydramnios on infants of small for gestional age

目的:探讨羊水过少对小于胎龄儿(SGA)的影响.方法:选取2000年1月～2003年12月在该院出生的单胎活产SGA全部病例共496例作为病例组,采用系统随机抽样方法选取同期出生的适于胎龄儿(AGA)500例为对照组,比较病例组及对照组新生儿母亲产前羊水过少(羊水指数≤8 cm)的比例.结果:①SGA病例组及AGA正常对照组母亲孕期羊水过少发病率分别为22.58%、4.80%(OR,95%CI=5.79,3.65～9.17);②分层分析表明,男性及女性SGA组母亲孕期羊水过少的比例分别是对照组的3.56(1.98～6.39)和13.81(5.48～34.80)倍;足月SGA组为对照组的5.79(3.58～9.37)倍.在校正胎儿性别、胎龄及孕母年龄后,SGA病例组母亲孕期的羊水过少发病比例是对照组的5.89(3.66～9.50)倍,与校正前接近.结论:研究结果显示产前羊水过少者SGA发生的危险性显著,可作为宫内筛查SGA的重要指征之一.

Objective： To explore the influence of oligohydramnios on infants of small for gestational age （SGA） . Methods： SGA group included 496 singleton alive SGA deliveris in this hospital during Jan 2000 to Dec 2003. 500 appropriate for gestational age （AGA） infants born during the same period were selected as the controls using a systematic random procedure. Ratios of intrapartum oligohydramnios （ amniotic fluid index ≤ 8 cm） between the case and control groups were compared. Results： Univariate analysis showed that the ratios of maternal oligohydramnios in the AGA and SGA group was 4. 80% and 22. 58% （112/496） （OR, 95% CI= 5. 79, 3. 65～9. 57）. The odds ratios （95 % CI） of oligohydramnios in the sub- groups of male, female and term neonates were 3. 56 （1. 98 ～ 6. 39）, 13. 81 （5. 48 ～34. 80） and 5. 79 （3. 58 ～9. 37）, respectively. After adjusting for maternal age, gestational age and infantg sex, the SGA group was 5. 89 （3. 66～9. 50） times higher to be oligohydramnios than that of the AGA group. Conclusion： Oligohydramnios significantly associate with SGA, which can serve as one of important indications for screening SGA.