| Objective(s):1.The measurement of fetal growth parameters has become an indispensable part of routine ultrasound in the second and third trimesters.Using the bi-parietal diameter(BPD),head circumference(HC),abdominal circumference(AC),and femur length(FL)ranges of the fetal growth map,the clinician can identify infants larger than gestational age(SGA),suitable for gestational age(AGA),or larger than gestational age(LGA)in a timely manner.In this study,the main growth parameters of fetuses at different gestational weeks under ultrasound in Kunming were discussed and the curves of fetal growth parameters suitable for this area were drawn.2.Since fetal growth is influenced by multiple factors,the purpose of this study is to establish an adjustable and personalized fetal birth weight standard for each regnant woman by evaluating maternal factors that affect fetal birth weight in the region,and estimate fetal growth potential(optimal weight and optimal range of fetal normal growth)based on the estimation of maternal genetic factors.And on this basis,compared with the actual weight of the fetus,to judge the growth and development of the fetus in utero,so that early detection of fetal growth and development abnormalities,timely intervention measures to improve the perinatal outcome.Methods: A total of 7583 full-term singlet parturients in The Second Affiliated Hospital of Kunming Medical Univercity obstetric Department from January 2021 to October 2022 were reviewed,excluding 4237 parturients with preterm birth,overdue pregnancy,complications and complications during pregnancy.1.The main growth parameter data of 1066 pregnant women with regular birth examination during pregnancy were collected,including double parial diameter,head circumference,abdominal circumference,femur length and ultrasound estimation of fetal weight.Through curve fitting analysis of the main growth parameters of the fetus at each gestational week,the growth curve was drawn and the regression equation of each parameter was established.2.The lying-in woman’s age,nationality,method of conception,pre-pregnancy height,weight,body mass index,gestational times,number of births,body mass index and weight at 20-24 weeks of gestation,and fetal sex,birth weight,gender and delivery gestational age were collected.Single factor analysis was carried out on all indicators and fetal birth weight,and multiple linear regression analysis was carried out on indicators with significant correlation to get regression equation,and the birth weight ratio equation established by Gardosi was used to generate personalized fetal growth curve model.Results:1.Fetal growth parameters(BPD,HC,AC,FL and EFW)were closely and positively correlated with gestational week,and the correlation coefficients R were 0.990,0.992,0.991,0.992,0.989.Through curve fitting,the percentile growth curve and regression equation of each parameter were established:BPD:Y=-3.215+0.421×GA+(-0.00006459×GA3);HC:Y=-11.460+1.546×GA+(-0.000265×GA3);AC:Y=-8.706+1.222×GA+(-0.0000857×GA3);FL:Y==-3.242+0.338×GA+(-0.0000434×GA3);EFW:Y=702.885-108.752×GA+4.515×GA2.2.(1)According to single factor regression analysis,maternal height,pre-pregnancy weight,pre-pregnancy BMI,20-24 weeks gestational weight and BMI,fetal sex,birth time and gestational age had significant effects on fetal birth weight(P< 0.05).(2)The standard women were: local,nationality is the Han,natural pregnant primipara without any pathological factors,159.5cm in height,59 kg at 20-24 weeks gestation,280 days of gestational age and 3427.5g of newborn.Through multiple linear regression analysis,the formula of optimal fetal birth weight in this region is obtained:TWO = 3427.5g + 18.92g/d(gestational age-280d)+ 7.2g/cm(height-159.5cm)+8.92g/kg(weight-59kg)+ maternal production time coefficient(if parity = 1;+98.6;parity =2;+100.45;parity ≥3;+105.7)+ fetal sex coefficient(sex = male,+67.8g;sex= female,-67.8g).Between 20 and 24 weeks of gestation,a personalized optimal fetal birth weight can be obtained by entering a formula based on the epidemiological factors of each pregnant woman.Conclusion(s):1.The growth curve can reflect the normal range of fetal growth.Since every population is diverse and the growth and development of the fetus varies among different populations and races,it is not appropriate to adopt the same standard for all people,and the growth curve established according to the population of the country or region should be used to improve the accuracy of prenatal SGA and FGR screening.Therefore,it is recommended that each individual population should have its own local fetal growth curve.2.In addition to pathological factors,maternal height,weight,gestational age,birth time and fetal sex also have significant effects on fetal birth weight.Therefore,the coefficients of these variables(influencing factors)can be calculated to build a personalized fetal growth curve model and evaluate fetal growth and development by estimating fetal weight monitoring. |
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