超声预测胎儿体质量方法比较及孕期增重对其准确性的影响研究OA北大核心CSTPCD
Comparison of Ultrasound Prediction Methods for Fetal Body Mass and the Effect of Pregnancy Weight Gain on Its Accuracy
目的:比较分析 11 种超声参数预测胎儿体质量公式的准确性,探讨孕期体质量增加(GWG)对超声估测胎儿体质量准确性的影响.方法:收集2020 年8 月至2020 年12 月于复旦大学附属金山医院分娩的502 例单胎,足月分娩产妇孕期增重、分娩前 7 天内胎儿超声测量指标及新生儿出生体质量,计算并分析多种超声预测公式的准确性.根据孕期体质量增长标准,即单胎妊娠孕前体质量指数(BMI)<18.5 kg/m2者孕期合理增重为12.5~18.0 kg,BMI 18.5~24.9 kg/m 2者增重11.5~16.0 kg,BMI 25.0~29.9 kg/m 2者增重7.0~11.5 kg,BMI≥30.0 kg/m2者增重5.0~9.0 kg,将病例分为GWG过少组(125 例)、正常组(202 例)和过多组(175 例),分析不同GWG对于超声预测胎儿体质量准确性的影响.结果:11 种超声参数预测胎儿体质量公式中,HadlockⅢ公式预测胎儿体质量的绝对误差为186.64±149.28 g,相对误差为(5.52±4.18)%,在 11 种预测公式中误差最小,差异有统计学意义(P<0.05),绝对误差和相对误差符合率分别为72.31%、86.25%,均为最高,差异有统计学意义(P<0.05).GWG过少组、正常组和过多组利用HadlockⅢ公式预测胎儿体质量时,绝对误差分别为190.23±136.69 g、148.12±99.39 g、228.54±189.57 g,相对误差分别为(5.95±4.25)%、(4.40±2.78)%、(6.49±5.09)%,差异均具有统计学意义(P<0.05).结论:HadlockⅢ公式预测胎儿体质量的准确性优于其他公式,但其准确性可受GWG的影响,临床中预测胎儿体质量时需多方面综合考量.
Objective:To compare the accuracy of 11 ultrasound parameters prediction formulas for fetal body mass,and to explore the effect of gestational weight gain(GWG)on the accuracy of ultrasound prediction of fetal body mass.Methods:A total of 502 single and full-term postpartum women who gave birth from August 2020 to December 2020 at Jinshan Hospital,Fudan University were collected.The gestational weight gain,fetal ultrasound measurement indicators within 7 days before delivery,and newborn birth weight were calculated and analyzed.The accuracy of multiple ultrasound prediction formulas were calculated and analyzed.According to the criteria for weight gain during pregnancy,the reasonable weight gain during pregnancy was 12.5-18.0 kg for singleton pregnancies with pre-pregnancy(body mass index)BMI<18.5 kg/m2,11.5-16.0 kg for those with BMI 18.5-24.9 kg/m2,7.0-11.5 kg for those with BMI 25.0-29.9 kg/m2,and 5.0-9.0 kg for those with BMI≥30.0 kg/m2.The cases were divided into the group with insufficient GWG(125 cases),the normal group(202 cases),and the group with too much GWG(175 cases)to analyze the effect of different GWG on the accuracy of ultrasound pre-diction of fetal body mass.Results:Among the 11 ultrasound parameter formulas for predicting fetal body mass,the HadlockⅢformula predicted fetal body mass with an absolute error of 186.64±149.28 g and a relative error of(5.52±4.18)%,which was the smallest error among 11 prediction formulas,with a statistically significant difference(P<0.05).The absolute and relative error compliance rates were 72.31%,86.25%,respectively,both of which were the highest,and the difference was statistically significant(P<0.05).When the HadlockⅢformula was used to predict birth weight in the insufficient GWG group,the normal group,and the group with too much GWG,the absolute errors were 190.23±136.69 g,148.12±99.39 g,228.54±189.57 g,and the relative errors were(5.95±4.25)%,(4.40±2.78)%,(6.49±5.09)%,respectively,and the differences were statistically significant(P<0.05).Conclusions:The accuracy of Hadlock Ⅲ formula in predicting fetal body mass is better than that of other formulas,but its accuracy can be affected by GWG,and it is necessary to consider multiple as-pects when estimating fetal body mass in clinical practice.
谢朝玲;秦川;刘颂平
复旦大学附属金山医院妇产科,上海 201508复旦大学附属金山医院超声科,上海 201508
临床医学
超声预测胎儿体质量体质量增长准确性
Ultrasound predictionFetal body massWeight gainAccuracy
《实用妇产科杂志》 2024 (003)
208-212 / 5
复旦大学附属金山医院后备学科平台建设项目(编号:HBXK-2021-1);复旦大学附属金山医院青年科研启动基金项目(编号:JYQN-LC-202106)
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