First-trimester utero-placental (vascular) development and embryonic and fetal growth: The Rotterdam periconception cohort
First-trimester utero-placental (vascular) development and embryonic and fetal growth: The Rotterdam periconception cohort
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DOI：
10.1016/j.placenta.2021.03.017
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发表时间：
2021-05-01
期刊：
影响因子：
3.8
通讯作者：
Steegers-Theunissen, R. P. M.
中科院分区：
文献类型：
--
作者：
Reijnders, I. F.;Mulders, A. G. M. G. J.;Steegers-Theunissen, R. P. M.
前言：胎盘发育受损是胎儿生长受限(FGR)的主要原因，因此，早期发现胎盘发育不良将改善产前护理和出生结局。在这里，我们旨在研究妊娠早期子宫胎盘(血管)发育的系列超声标志物与胚胎和胎儿生长的关系。方法：在前瞻性队列中，我们包括214名孕妇。应用三维能量多普勒超声测量胎盘体积(PV)、胎盘基底板表面积(TM)和子宫胎盘血管体积(UPVV)、冠臀长度(CRL)、胚胎体积(EV)。在妊娠22周和32周分别用超声测量胎儿体重(EFW)，并记录出生体重百分位数(BW)。采用了线性混合模型和回归分析，并进行了适当调整。结果：PV轨迹与CRL(beta(Adj)=0.416，95%CI：0.255；0.576，p<；0.001)、EV(beta(Adj)=0.220，95%CI：0.058；0.381，p=0.008)和EFW(beta(Adj)=0.182，95%CI：0.012；0.352，p=0.037)呈正相关。UPVV轨迹与CRL呈正相关(β(Adj)=0.203，95%可信区间0.021；0.384，p=0.029)。在女孩中，PV轨迹与CRL(p<；0.001)、EV(p=0.018)、EFW(p=0.026)呈正相关，uPVV轨迹与体重呈正相关(p=0.040)。在男孩中，PV轨迹与CRL呈正相关(p=0.002)，uPVV轨迹与CRL呈正相关(p=0.046)。讨论：妊娠早期子宫胎盘(血管)发育与胚胎和胎儿生长有关，并与胎儿性别特异性改变有关。这强调了监测妊娠早期胎盘发育的机会，并支持了与胚胎和胎儿生长的关系。
Introduction: Impaired placental development is a major cause of fetal growth restriction (FGR) and early detection will therefore improve antenatal care and birth outcomes. Here we aim to investigate serial first-trimester ultrasound markers of utero-placental (vascular) development in association with embryonic and fetal growth.Methods: In a prospective cohort, we periconceptionally included 214 pregnant women. Three-dimensional power Doppler ultrasonography at 7, 9 and 11 weeks gestational age (GA) was used to measure placental volumes (PV) and basal plate surface area by Virtual Organ Computer-aided AnaLysis (TM), and utero-placental vascular volume (uPVV), crown-rump length (CRL) and embryonic volume (EV) by a V-scope volume rendering application. Estimated fetal weight (EFW) was measured by ultrasound at 22 and 32 weeks GA and birth weight percentile (BW) was recorded. Linear mixed models and regression analyses were applied and appropriately adjusted. All analyses were stratified for fetal sex.Results: PV trajectories were positively associated with CRL (beta(adj) = 0.416, 95%CI:0.255; 0.576, p < 0.001), EV (beta(adj) = 0.220, 95%CI:0.058; 0.381, p = 0.008) and EFW (beta(adj) = 0.182, 95%CI:0.012; 0.352, p = 0.037). uPVV trajectories were positively associated with CRL (beta(adj) = 0.203, 95%CI 0.021; 0.384, p = 0.029). In girls, PV trajectories were positively associated with CRL (p < 0.001), EV (p = 0.018), EFW (p = 0.026), and uPVV trajectories were positively associated with BW (p = 0.040). In boys, positive associations were shown between PV trajectories and CRL (p = 0.002), and between uPVV trajectories and CRL (p = 0.046).Discussion: First-trimester utero-placental (vascular) development is associated with embryonic and fetal growth, with fetal sex specific modifications. This underlines the opportunity to monitor first-trimester placental development and supports the associations with embryonic and fetal growth.