孕中晚期胎儿宫内生长的影响因素研究  

Study on the influencing factors of fetal intrauterine growth in the middle and late pregnancy

作　　者：彭美娟 吴云[3] 蒋涛 吕红 周婷[3] 吴丽君 蒋杨倩 林苑 杜江波[1,2] 石中华 陈婷[5] 吴亮[6] 靳光付[1,2] PENG Meijuan;WU Yun;JIANG Tao;LV Hong;ZHOU Ting;WU Lijun;JIANG Yangqian;LIN Yuan;DU Jiangbo;SHI Zhonghua;CHEN Ting;WU Liang;JIN Guangfu(Department of Epidemiology,School of Public Health,Nanjing Medical University,Nanjing 211166;State Key Laboratory of Reproductive Medicine,Nanjing Medical University,Nanjing 211166;Department of Ultrasound,Women’s Hospital of Nanjing Medical University(Nanjing Maternity and Child Health Hospital),Nanjing 210011,China;Department of Obstetrics,Women’s Hospital of Nanjing Medical University(Nanjing Maternity and Child Health Hospital),Nanjing 210011,China;Scientific Education Section,Women’s Hospital of Nanjing Medical University(Nanjing Maternity and Child Health Hospital),Nanjing 210011,China;Information Section,Women’s Hospital of Nanjing Medical University(Nanjing Maternity and Child Health Hospital),Nanjing 210011,China)

机构地区：[1]南京医科大学公共卫生学院流行病学系,江苏南京211166 [2]南京医科大学公共卫生学院生殖医学国家重点实验室,江苏南京211166 [3]南京医科大学附属妇产医院(南京市妇幼保健院)超声科,江苏南京210011 [4]南京医科大学附属妇产医院(南京市妇幼保健院)产科,江苏南京210011 [5]南京医科大学附属妇产医院(南京市妇幼保健院)科教科,江苏南京210011 [6]南京医科大学附属妇产医院(南京市妇幼保健院)信息科,江苏南京210011

出　　处：《南京医科大学学报（自然科学版）》2021年第5期763-768,共6页Journal of Nanjing Medical University(Natural Sciences)

基　　金：江苏省高等学校自然科学研究重大项目(20KJA310003);国家自然科学基金青年科学基金(8200120815)。

摘　　要：目的:探讨影响胎儿孕中晚期宫内生长的母体和孕期相关因素。方法:收集在南京医科大学附属妇产医院产检并分娩的孕妇孕期B超监测数据及母体和孕期健康相关信息。纳入在2016年8月—2019年5月孕满20周并在孕22~24周、孕30~32周和孕34~36周均有B超检查的单胎活产家庭,共计1457个家庭。本研究通过B超采集的胎儿双顶径(biparietal diameter,BPD)、头围(head circumference,HC)、腹围(abdomen circumference,AC)和股骨长(femur length,FL)数据,计算获得胎儿估计体重(estimated fetal weight,EFW),并采用混合线性模型分析孕中晚期宫内生长的影响因素。结果:在多因素分析中发现,母亲年龄与孕22~24周、孕30~32周和孕34~36周的EFW均呈正相关;与孕前体重指数(body mass index,BMI)在正常范围(18.5 kg/m^(2)≤BMI<24 kg/m^(2))的母亲相比,孕前BMI偏低(BMI<18.5 kg/m^(2))的母亲孕30~32周和孕34~36周胎儿更小,孕前超重或肥胖的母亲(BMI>24 kg/m^(2))胎儿更大;女胎EFW在孕22~24周、孕30~32周和孕34~36周始终显著小于男胎。此外,发现孕前痛经与孕期EFW呈显著负相关。结论:母亲年龄、孕前BMI、胎儿性别以及痛经可能影响胎儿估计体重。Objective:This study aims to explore maternal factors and pregnancy related factors affecting intrauterine growth in mid and late pregnancy.Methods:We collected ultrasound data and maternal and health-related information during pregnancy of women who received antenatal examination and delivered in the Women’s Hospital of Nanjing Medical University.A total of 1457 singleton live birth whose mother had pregnancies of at least 20 gestational weeks between August 2016 and May 2019 and received ultrasound examinations at 22-24,30-32 and 34-36 gestational weeks.Estimated fetal weight(EFW)was calculated based on head circumference(HC),abdomen circumference(AC)and femur length(FL)measured by ultrasound,and and the related factors of intrauterine growth in the middle and late pregnancy were analyzed by mixed linear model.Results:In multivariate analysis,maternal age was positively correlated with EFW at 22-24,30-32 and 34-36 gestational weeks.Compared with mothers with normal pre-pregnancy BMI(18.5 kg/m^(2)≤BMI<24 kg/m^(2)),mothers with underweight(BMI<18.5 kg/m^(2))had smaller fetuses,and mothers with pregestational overweight/obesity(BMI>24 kg/m^(2))have larger fetuses at 30-32 and 34-36 gestational weeks.EFW of girls was significantly smaller than that of boys at 22-24,30-32 and 34-36 weeks of gestation.Moreover,We found that pre-pregnancy dysmenorrhea was significantly negatively correlated with EFW during pregnancy.Conclusion:Maternal age,pre-pregnancy BMI,fetal sex and dysmenorrhea may affect estimated fetal weight.

关 键 词：胎儿宫内生长 影响因素 

分 类 号：R714.51[医药卫生—妇产科学]