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首页> 外文期刊>European Journal of Obstetrics, Gynecology and Reproductive Biology: An International Journal >First trimester growth restriction and uterine artery blood flow in the second trimester as predictors of adverse pregnancy outcome
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First trimester growth restriction and uterine artery blood flow in the second trimester as predictors of adverse pregnancy outcome

机译：孕早期的生长受限和孕中期的子宫动脉血流可预测不良妊娠结局

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Objectives: To investigate if fetuses with first trimester growth restriction have poorer perfusion of the placenta compared to a control group, and to investigate whether first trimester growth restriction in combination with poor flow in the uterine arteries in the second trimester can be used to predict poor outcome. Study design: Women with singleton pregnancies, where the gestational age estimated by crown-rump length (CRL) at the first trimester scan was 7 days or more smaller than the gestational age estimated by last menstrual period, and a control group of women, where the gestational age was either equal to or 1 day larger than the gestational age estimated by last menstrual period, were invited to join the study. The study entailed the routine scans; Down syndrome screening in gestational week 11-14 and an anomaly scan in gestational week 18-21. In addition to the routine scans the participants were offered a growth scan in gestational week 23-24. At the anomaly scan and growth scan, umbilical and uterine artery Doppler flows were measured. Results: 182 cases and 230 controls were included in the study. The case and control groups showed no significant differences in placental blood flow characteristics at 18-21 weeks or 23-24 weeks. In our logistic regression models the only outcome that showed a significant association to the case group was birth weight below 2500 g. Having a CRL 7 days or more smaller than expected increased the risk of having a child with a birth weight below 2500 g with an odds ratio of 3.29. Conclusions: We were unable to demonstrate a link between first trimester growth restriction and poor placental perfusion. The case group had increased risk of birth weight below 2500 g, but only with an odds ratio of 3. Therefore we do not recommend implementation of uterine or umbilical artery flow measurements specifically for fetuses with first trimester growth restriction.
机译：目的：研究与对照组相比，妊娠中期发育受限的胎儿胎盘灌注是否较差，并调查妊娠中期发育受限，妊娠中期子宫动脉流量不足是否可用于预测不良结果。研究设计：单胎妊娠的妇女，其妊娠前三个月通过冠臀长（CRL）估算的胎龄比上一次月经期估算的胎龄小7天或更多，而对照组为女性，其中妊娠年龄等于或大于上次月经估计的妊娠年龄1天，被邀请参加研究。该研究需要常规扫描。在妊娠第11-14周进行唐氏综合症筛查，在妊娠第18-21周进行异常扫描。除了常规扫描外，在妊娠第23-24周还为参与者提供了生长扫描。在异常扫描和生长扫描时，测量脐带和子宫动脉多普勒血流。结果：182例和230例对照被纳入研究。病例组和对照组在18-21周或23-24周时胎盘血流特征无明显差异。在我们的逻辑回归模型中，唯一显示出与病例组显着相关的结果是出生体重低于2500 g。 CRL比预期小7天或更长时间会增加出生体重低于2500 g，比值比为3.29的孩子的风险。结论：我们无法证明孕早期生长受限与胎盘灌注不良之间的联系。病例组出生体重低于2500 g的风险增加，但比值比仅为3。因此，我们不建议专门针对早孕期生长受限的胎儿进行子宫或脐动脉血流测量。

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