小于胎龄儿临床分型及其与围生期因素相关性探讨  

Relationship between clinical classifications and perinatal factors in small for gestational age infants

作　　者：肖作源[1] 唐新意[1] 陈裕明[2] 牟一坤[1] 谷进[3] 

机构地区：[1]中山大学附属第三医院儿科,广州510630 [2]中山大学卫生学院 [3]中山大学附属第三医院产科,广州510630

出　　处：《中国实用儿科杂志》2003年第7期408-410,共3页Chinese Journal of Practical Pediatrics

摘　　要：目的　分析小于胎龄儿 (SGA)的临床分型情况以及母妊高征、羊水过少、宫内发育迟缓 (IUGR)的初诊孕周等围生因素对SGA临床分型的影响。方法　采用回顾性调查方法 ,对 4 17例SGA根据《中华儿科杂志》SGA的分型标准及定义进行分型 ,并用统计学方法对不同临床分型结果及其与母妊高征、羊水过少、IUGR初诊孕周的相关性进行分析。结果　① 4 17例SGA中按重量指数或按身长 /头围比值分为匀称型 376例 (90 16 % ) ,非匀称型 4 1例 (9 83% )。两种分型方法结果的符合率为 80 8%。②根据SGA定义分型则匀称型SGA187例(4 4 84 % ) ,非匀称型 2 30例 (5 5 15 % ) ,与重量指数和身长 /头围比值分型的符合率分别为 4 9 8%和 5 0 8%。③母妊高征、羊水过少及IUGR初诊孕周与三种SGA临床分型结果的相关性无统计学意义。结论　目前我国的重量指数及身长 /头围比值两种分型方法与按SGA定义分型的符合率较低 ,母妊高征、羊水过少及IUGR初诊孕周对SGA的临床分型无影响 ,有必要重新探讨的SGA定义分型及重新认识SGA的发病机制及母围生因素对SGA分型的影响。Objective To evaluate the clinical classifications of small for gestational age infants (SGA) by different criteria and assess the effects of PIH,oligohydramnios,the first confirmed gestational age(wk) of IUGR on the classifications.Methods 417 SGA were diagnosed using criteria of SGA definition and other criteria released in Chinese Journal of Pediatrics in 1997.The prevalence of symmetric SGA of their mothers with and without PIH,oligohydramnios and the first confirmed gestational age of IUGR was compared.Results 376 of 416 (90.6%) SGA were classified as symmetric infants using ponderal index(PI)and body length to head circumference ratio (BL/HC).The rate of exact agreement was 80.8%.However,according to the SGA definition,only 187 of 416 (44.84%) SGA were regarded as symmetric infants.The agreement rate was 49^8% and 50^8%,respectively.There wasn't any significant difference in the prevalence of symmetric infants between their mothers with and without PIH or oligohydramnios,and in the first confirmed gestational age of IUGR between symmetric and asymmetric infants (P>0.05).Conclusion As compared with the definition criterion,the criteria of PI or BL/HC showed low agreement rates in the clinical classifications of SGA.The symmetric rate of SGA was not significantly affected by PIH,oligohydramnios and the first confirmed gestational age of IUGR in this study.Further studies are needed to evaluate the classification and the effects of perinatal influence factors on the classification.

关 键 词：小于胎龄儿 临床分型 围生期 妊高征 羊水过少 宫内发育迟缓 回顾性调查方法 

分 类 号：R714.5[医药卫生—妇产科学]