CUSTOMIZED ANTENATAL GROWTH CHARTS
CUSTOMIZED ANTENATAL GROWTH CHARTS
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DOI：
10.1016/0140-6736(92)91342-6
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发表时间：
1992-02-01
期刊：
影响因子：
168.9
通讯作者：
SYMONDS, EM
中科院分区：
文献类型：
--
作者：
GARDOSI, J;CHANG, A;SYMONDS, EM
胎儿生长图表不考虑生理变量。因此，我们设计了一个计算机生成的产前图表，可以很容易地“定制”为每个单独的怀孕，考虑到母亲的特点和出生体重从以前的怀孕。在英国诺丁汉女王医学中心对4179例经超声证实的妊娠日期的回顾表明，除了妊娠和性别外，首次产前检查时的孕妇体重、身高、种族、和产次是我们人口中出生体重的重要决定因素。计算每个变量的校正因子，并输入计算机程序以调整正常出生体重百分位数限值。通过调整百分位数，我们发现28%的婴儿通常被指定为小于胎龄（<第10百分位数），22%的婴儿被指定为大于胎龄（>第90百分位数），实际上是在正常范围内的怀孕。相反，24%和26%的婴儿被确定为小或大，调整百分位数分别是“错过”的传统未经调整的百分位数评估。调整生理变量将使评估胎儿生长更准确，减少不必要的调查，干预和父母的焦虑。
Charts for fetal growth do not take physiological variables into account. We have therefore designed a computer-generated antenatal chart that can be easily "customised" for each individual pregnancy, taking the mother's characteristics and birthweights from previous pregnancies into consideration. The adjusted birthweight range expected at 40 weeks' gestation is combined with a standard, longitudinal ultrasound-derived curve for intrauterine weight gain.Review at the Queen's Medical Centre, Nottingham, UK, of 4179 pregnancies with ultrasound-confirmed dates showed that, in addition to gestation and sex, maternal weight at first antenatal-clinic visit, height, ethnic group, and parity were significant determinants of birthweight in our population. Correction factors were calculated for each of these variables and entered into a computer program to adjust the normal birthweight centile limits. With adjusted centiles we found that 28% of babies conventionally designated small for gestational age (< 10th centile) and 22% of those designated large (> 90th centile) were in fact within normal limits for the pregnancy. Conversely, 24% and 26% of babies identified as small or large, respectively, with adjusted centiles were "missed" by conventional unadjusted centile assessment.Adjustment for physiological variables will make assessment of fetal growth more precise and reduce unnecessary investigations, interventions, and parental anxiety.