产前超声测量胎儿腹围对预测巨大儿的临床价值

Clinical value of prenatal ultrasonographic measurement of fetal abdominal circumference in predicting macrosomia

目的研究产前超声测量胎儿腹围对预测巨大儿的临床价值。方法根据出生时体重,将我院出生的839例新生儿分为巨大儿组(n=81)与非巨大儿组(n=758),对两组胎儿在妊娠30周时超声检测腹围的结果进行回顾性分析,比较两组新生儿的腹围。结果妊娠30周时,巨大儿组胎儿的腹围、双顶径、头围及股骨长均显著长于非巨大儿组(P<0.05)。腹围预测巨大儿的最佳临界值为268.21 mm,以此临界值进行的巨大儿预测,灵敏度为53.1%,特异度为83.9%,约登指数为0.370,AUC为0.738(95%CI为0.675～0.809)。胎儿腹围同其出生体重之间呈显著正相关(r=0.598,P<0.05)。结论在妊娠30周时对胎儿腹围进行超声检测可用于新生儿体重异常的判断及巨大儿的预测,当胎儿腹围超过268.21 mm时,巨大儿预测的临床价值较为突出。

Objective To study the clinical value of prenatal ultrasonographic measurement of fetal abdominal circumference in predicting macrosomia.Methods According to the birth weight,839 newborns born in our hospital were divided into macrosomia group(n=81)and non-macrosomia group(n=758).The results of abdominal circumference detected by ultrasound at 30 weeks of gestation in both groups were retrospectively analyzed,and the abdominal circumference between newborns of the two groups were compared.Results At 30 weeks of gestation,fetal abdominal circumference,biparietal diameter,head circumference and femoral length in the macrosomia group were significantly longer than those in the nonmacrosomia group(P<0.05).The best critical value of abdominal circumference for macrosomia prediction was 268.21 mm.The sensitivity,specificity,Youden index and AUC were 53.1%,83.9%,0.370 and 0.738(95%CI was 0.675-0.809).There was a significant positive correlation between fetal abdominal circumference and birth weight(r=0.598,P<0.05).Conclusion Ultrasound detection of fetal abdominal circumference at 30 weeks of gestation can be used to judge abnormal neonatal weight and predict macrosomia.When the fetal abdominal circumference is more than 268.21 mm,the clinical value of macrosomia prediction is more prominent.