Outcome of fetuses with short femur length detected at second-trimester anomaly scan: a national survey
Outcome of fetuses with short femur length detected at second-trimester anomaly scan: a national survey
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DOI：
10.1002/uog.13286
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发表时间：
2014-08-01
影响因子：
7.1
通讯作者：
Tabor, A.
中科院分区：
文献类型：
--
作者：
Mathiesen, J. M.;Aksglaede, L.;Tabor, A.
目的评估发现胎儿股骨骨干长度（FL）低于第5百分位数在中期妊娠扫描和妊娠结局之间的关系，在人口中，超过90%的妇女参加早期妊娠screening.Methods这是一项回顾性研究，所有丹麦单胎妊娠17-22周异常扫描2008年1月1日至2011年6月30日。异常扫描时FL和胎龄（GA）的信息，从丹麦胎儿医学数据库中获得了2718例短FL，在147766例胎儿中，（16.2%）（阳性似然比（LR+）8.8（95% CI，5.1-15.2））。13/18三体和不平衡的常染色体结构异常也分别与3例（12.0%，LR+ 6.5（95%CI，2.3-18.9））和8例（32.0%，LR+ 17.4（95%CI，9.8-30.9））病例中的短FL相关。胎儿患有21三体、18三体、13三体或不平衡常染色体结构异常的风险为1：123（95%CI，79-192）。胎儿FL短的妊娠更常受到早期早产的影响（34周前）（5.6%;比值比（OR）= 4.2（95% CI，3.5-4.9））和小于胎龄（SGA）婴儿（13.9%; OR = 4.3（95% CI，结论在中期妊娠异常扫描中短FL与染色体异常的相对风险显著增高相关，SGA和早期早产的绝对风险显著更高。版权所有（C）2013 ISUOG.由John Wiley & Sons有限公司出版
Objective To assess the relationship between the finding of fetal femur diaphysis length (FL) below the 5th percentile at the second-trimester scan and pregnancy outcome, in a population in which more than 90% of women attend first-trimester screening.Methods This was a retrospective study of all Danish singleton pregnancies with a 17-22-week anomaly scan between 1 January 2008 and 30 June 2011. Information on FL and gestational age (GA) at anomaly scan, on birth weight and GA at delivery and on chromosomal abnormalities was obtained from the Danish Fetal Medicine Database.Results Short FL was identified in 2718 (1.8%) of 147 766 fetuses and was present in 11 (16.2%) of the 68 fetuses affected by trisomy 21 (positive likelihood ratio (LR+) 8.8 (95% CI, 5.1-15.2)). Trisomy 13/18 and unbalanced autosomal structural abnormalities were also associated with a short FL in three (12.0%, LR+ 6.5 (95% CI, 2.3-18.9)) and eight (32.0%, LR+ 17.4 (95% CI, 9.8-30.9)) of the cases, respectively. The risk of a fetus having trisomy 21, trisomy 18, trisomy 13 or an unbalanced autosomal structural abnormality was 1 : 123 (95% CI, 79-192), given a short FL. Pregnancies with a fetus with short FL were more often affected by early preterm delivery (before 34 weeks) (5.6%; odds ratio (OR) = 4.2 (95% CI, 3.5-4.9)) and small-for-gestational-age (SGA) infants (13.9%; OR = 4.3 (95% CI, 3.8-4.8)).Conclusion Short FL at the second-trimester anomaly scan is associated with a significantly higher relative risk of chromosomal abnormalities, and a substantially higher absolute risk for SGA and early preterm delivery. Copyright (C) 2013 ISUOG. Published by John Wiley & Sons Ltd.