Exploring the use of UmbiFlow ™ to assess the impact of heat stress on fetoplacental blood flow in field studies
Exploring the use of UmbiFlow ™ to assess the impact of heat stress on fetoplacental blood flow in field studies
复制标题
在现场研究中探索使用 UmbiFlow™ 评估热应激对胎儿胎盘血流的影响
DOI：
10.1101/2022.03.31.22273092
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Bonell A
中科院分区：
文献类型：
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作者：
Bonell A
目的评估热应激对脐动脉阻力指数（RI）测量UmbiFlow™在现场设置和怀孕outcome.MethodsThis可行性研究的影响进行了在江西，冈比亚，西非，农村地区，暴露于极端高温。我们招募了在怀孕期间从事体力劳动（如耕作）的单胎胎儿妇女。对妊娠≥ 28周的孕妇在休息时、轮班期间和轮班结束时测量脐动脉RI。不良妊娠结局（APO）被归类为死产，早产，低出生体重，或小于胎龄儿，和所有其他的结果为normal.ResultsA共40名参与者包括23名正常分娩和17 APO。脐动脉RI表现出与热应激的非线性关系，通用热气候指数表明胎盘功能不全的潜在阈值约为32ºC。初步证据表明，胎儿胎盘循环对热应激的反应在APO与正常outcome.ConclusionsThe Umbiflow™设备被证明是一种有效的现场方法评估胎盘功能不同。RI的动态变化可能开始解释极端高温和APO.FundingThe Wellcome Trust（216336/Z/19/Z）概要极端高温暴露正在增加，低成本的脐动脉多普勒设备UmbiFlow™可以帮助了解热应激条件下的胎儿胎盘功能。
ObjectiveTo evaluate the impact of heat stress on umbilical artery resistance index (RI) measured by UmbiFlow™ in field settings and the implications for pregnancy outcomes.MethodsThis feasibility study was conducted in West Kiang, The Gambia, West Africa; a rural area with increasing exposure to extreme heat. We recruited women with singleton fetuses who performed manual tasks (such as farming) during pregnancy. The umbilical artery RI was measured at rest, during and at the end of a typical working shift in women ≥ 28 weeks’ gestation. Adverse pregnancy outcomes (APO) were classified as stillbirth, preterm birth, low birth weight, or small for gestational age, and all other outcomes as normal.ResultsA total of 40 participants were included; 23 normal births and 17 APO. Umbilical artery RI demonstrated a nonlinear relationship to heat stress, with indication of a potential threshold value for placental insufficiency around 32ºC by universal thermal climate index. Preliminary evidence suggests the fetoplacental circulation response to heat stress differs in APO versus normal outcome.ConclusionsThe Umbiflow™ device proved to be an effective field method for assessing placental function. Dynamic changes in RI may begin to explain the association between extreme heat and APO.FundingThe Wellcome Trust (216336/Z/19/Z)SynopsisExtreme heat exposure is increasing and a low-cost umbilical artery doppler device, UmbiFlow™, can aid understanding of fetoplacental function under heat stress conditions.