早发型和晚发型胎儿生长受限相关情况比较

Comparison of early-onset and late-onset fetal-growth-restriction

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。

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.