新生儿体重及巨大儿预测的诊断性试验评价  

Diagnostic test evaluation of neonatal weight and macrosomia prediction

作　　者：高婷婷 杨芳 GAO Tingting;YANG Fang(Gynecology and Obstetrics Department,the Second Affiliated Hospital of Air Force Military Medical University,Xi'an 710038,China)

机构地区：[1]空军军医大学第二附属医院妇产科,陕西西安710038

出　　处：《临床医学研究与实践》2024年第19期109-112,共4页Clinical Research and Practice

摘　　要：目的比较预测新生儿出生体重的5种公式,以找出一种准确度较高的公式。方法选取2019年5月至2021年9月于本院产科住院的168名单胎足月孕妇为研究对象,测量孕妇宫高、腹围(AC),超声检测胎儿腹围(FAC)、头围(HC)、双顶径(BPD)、股骨长(FL),分别用5种公式计算胎儿体重。以出生体重为金标准,分别计算5种公式的灵敏度、特异度、假阴性率、假阳性率、准确度、阳性预测值、阴性预测值、约登指数、阳性似然比和阴性似然比。结果通过5种公式对巨大儿、非巨大儿筛查出的数量和实际巨大儿、非巨大儿的数量进行计算比较,实际巨大儿发生率为10.12%(17/168)。公式5的灵敏度最高,为70.59%;其次为公式3、4,均为58.82%;公式1、2、3、4、5的准确度分别为89.29%、88.69%、89.88%、88.10%、87.50%,5种公式的准确度较为接近。结论巨大儿可能带来诸多不良妊娠结局,公式2联合宫高≥38 cm(公式5)对巨大儿预测的灵敏度更高,可作为产科医生判断巨大儿的主要参考依据,指导产程处理,减少母婴并发症发生。Objective To compare five formulas for predicting neonatal birth weight in order to find a formula with high accuracy.Methods A total of 168 singleton full-term pregnant women who were hospitalized in the obstetrics department of our hospital from May 2019 to September 2021 were selected as the research objects.The uterine height and abdominal circumference(AC)of pregnant women were measured.Fetal abdominnal circumference(FAC),head circumference(HC),biparietal diameter(BPD)and femoral diaphysis length(FL)were measured by ultrasound,fetal weight was calculated by five formulas.Taking birth weight as the gold standard,the sensitivity,specificity,false negative rate,false positive rate,accuracy,positive predictive value,negative predictive value,Youden index,positive likelihood ratio and negative likelihood ratio of the five formulas were calculated respectively.Results Five formulas were used to calculate and compare the number of macrosomia and non-macrosomia screened and the actual number of macrosomia and non-macrosomia,the actual incidence of macrosomia was 10.12%(17/168).The sensitivity of formula 5 was the highest,which was 70.59%;followed by formulas 3 and 4,both of which were 58.82%;the accuracy of formula 1,2,3,4 and 5 was 89.29%,88.69%,89.88%,88.10%and 87.50%,respectively,the accuracy of the five formulas was close.Conclusion Macrosomia may bring many adverse pregnancy outcomes.Formula 2 combined with uterine height≥38 cm(formula 5)has higher sensitivity in predicting macrosomia,which can be used as the main reference bass for obstetricians to judge macrosomia,guide labor process and reduce maternal and infant complications.

关 键 词：新生儿体重 巨大儿 预测 

分 类 号：R715.3[医药卫生—妇产科学]