超声检测胎儿腹围及半肩径对新生儿体重的预测

目的 分析超声检测胎儿腹围及半肩径对新生儿体重的预测价值.方法 选取承德市妇幼保健院自2015年4月至2016年4月收治的200例足月新生儿作为研究对象,按照出生时的实际体重分为非巨大儿179例及巨大儿21例,对两组胎儿在妊娠30周时的超声检测腹围及半肩径结果进行回顾性分析.结果 巨大儿组较非巨大儿组相比腹围、半肩径均较大,差异均具有统计学意义(t值分别为4.14、3.25,均P＜0.05).腹围大于267.90mm和(或)半肩径大于75.00mm,腹围最佳临界值预测巨大儿的灵敏度为71.43％、特异度为61.90％,约登指数为0.334,ROC曲线下面积为0.693(95％ CI:0.613 ～0.773).半肩径最佳临界值预测巨大儿的灵敏度为76.19％、特异度为66.67％,约登指数为0.429,ROC曲线下面积为0.723(95％ CI:0.649～0.799).胎儿腹围和半肩径与出生体重均呈正相关(r值分别为0.603、0.661,均P＜0.05),即胎儿腹围、半肩径增大,其出生体重增加.结论 于妊娠30周时采用超声检测胎儿的腹围及半肩径可作为判断新生儿体重异常与否的重要指标,当腹围大于267.90mm和(或)半肩径大于75.00mm对预测巨大儿有一定的临床价值.

Predicting neonatal weight by detecting fetal abdominal circumference and half shoulder diameter with ultrasonography

Objective Analyze the predicting value of detecting fetal abdominal circumference and half shoulder diameter with ultrasonography on neonatal weight.Methods From April 2015 to April 2016 200 cases of full-term newborns were selected from Chengde Maternal and Child Health Care Hospital as research objects,and they were divided into non-macrosomia group (179 cases) and macrosomia (21 cases) according to actual birth weight.Abdominal circumference and half shoulder diameter at 30 weeks of gestation were analyzed retrospectively for two groups.Results Compared to the non-macrosomia group,abdominal circumference and half shoulder diameter were larger than those in macrosomia group,and the differences were statistically significant (t value was 4.14 and 3.25,respectively,both P ＜ 0.05).When abdominal circunfference was larger than 267.90mm and (or) half shoulder diameter was larger than 75.00mm,the sensitivity of best threshold of abdominal circumference to predict macrosomia was 71.43％,the specificity was 61.90％,Youden index was 0.334,and area under ROC curve was 0.693 (95％ CI:0.613-0.773).The sensitivity of best threshold of half shoulder diameter to predict macrosomia was 76.19％,the specificity was 66.67％,Youden index was 0.429,and area under ROC curve was 0.723 (95％ CI:0.649-0.799).Fetal abdominal circumference and half shoulder diameter were positively correlated with birth weight (r value was 0.603 and 0.661,respectively,both P ＜ 0.05).Conclusion Fetal abdominal circumference and half shoulder diameter detected at 30 weeks of gestation with ultrasonic examinafion can be taken as important indicators to judge birth weight.Abdominal circumference greater than 267.90 mm and (or) half shoulder diameter greater than 75.00 mm are of certain clinical value in predicting macrosomia.