Macrosomia has its roots in early placental development.
Macrosomia has its roots in early placental development.
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DOI：
10.1016/j.placenta.2014.06.373
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发表时间：
2014-09
期刊：
影响因子：
3.8
通讯作者：
Parry S
中科院分区：
文献类型：
--
作者：
Schwartz N;Quant HS;Sammel MD;Parry S
我们试图确定通过 3 维超声检查测量的早期胎盘大小是否与分娩巨大儿或大于胎龄 (LGA) 婴儿的风险增加相关。我们前瞻性地收集了 11-14 周和 18-24 周单胎妊娠的 3 维超声体积集。从医疗记录中收集出生体重。分娩后，使用超声体积集测量胎盘体积（PV）和胎盘商（PQ=PV/胎龄），以及平均胎盘和绒毛膜直径（分别为MPD和MCD）。分析胎盘测量作为巨大儿（出生体重≥4000克）和LGA（出生体重≥90%）的预测因子。 578 例妊娠早期的妊娠包括 44 例（7.6%）巨大儿和 43 例（7.4%）LGA 婴儿。 373 名受试者还获得了中期妊娠卷。在妊娠早期和中期，较高的 PV 和 PQ 均与巨大儿和 LGA 显着相关。妊娠中期 MPD 也与这两种结果显着相关，而妊娠中期 MCD 仅与 LGA 相关。在调整种族、民族、年龄和糖尿病等母亲人口统计变量后，上述关联仍然显着。调整后的模型对巨大儿和 LGA 产生了中等预测（AUC：0.71-0.77）。早期胎盘的超声测量可以识别巨大儿和 LGA 风险较高的妊娠。巨大儿和 LGA 已部分由早期胎盘生长和发育决定。
We sought to determine if early placental size, as measured by 3-dimensional ultrasonography, is associated with an increased risk of delivering a macrosomic or large-for-gestational age (LGA) infant. We prospectively collected 3-dimensional ultrasound volume sets of singleton pregnancies at 11–14 weeks and 18–24 weeks. Birth weights were collected from the medical records. After delivery, the ultrasound volume set were used to measure the placental volume (PV) and placental quotient (PQ=PV/gestational age), as well as the mean placental and chorionic diameters (MPD and MCD, respectively). Placental measures were analyzed as predictors of macrosomia (birth weight ≥4000 grams) and LGA (birth weight ≥90th percentile). The 578 pregnancies with first trimester volumes included 44 (7.6%) macrosomic and 43 (7.4%) LGA infants. 373 subjects also had second trimester volumes available. A higher PV and PQ were both significantly associated with macrosomia and LGA in both the first and second trimesters. Second trimester MPD was significantly associated with both outcomes as well, while second trimester MCD was only associated with LGA. The above associations remained significant after adjusting for maternal demographic variables such as race, ethnicity, age and diabetes. Adjusted models yielded moderate prediction of macrosomia and LGA (AUC: 0.71–0.77). Sonographic measurement of the early placenta can identify pregnancies at greater risk of macrosomia and LGA. Macrosomia and LGA are already determined in part by early placental growth and development.