Study On Risk Factors Of Fetal Growth Restriction

Objective To explore the high risk factors of fetal grow restriction(FGR),and further guide clinical monitoring.Methods1.From January 2017 to October 2018,a total of 18,401 cases of pregnant women with full-term,single live birth and no fetal abnormality who were hospitalized in the obstetrics department of huzhong hospital in huadu district,guangzhou city were retrospectively analyzed.2.The correlation between pregnancy hypertension,preeclampsia,intrahepatic cholestasis of pregnancy,oligohydramnios,anemia,placenta abnormality,hypothyroidism,diabetes mellitus,older pregnancy and fetal growth restriction was analyzed.3.In this study,SPSS 23.0 statistical analysis software was used to express the continuous variables of normal distribution with(x±s),the continuous variables of skewness distribution with median(quartile spacing),the classification variables were described by rate or composition ratio,and the factors affecting FGR were analyzed by chi-square test and multiple logistic regression analysis.The test level was a=0.05,with P<0.05 as the statistical significance.Results1.Among 18401 pregnant women,493 combined with hypothyroidism,370 combined with gestational hypertension,3647 combined with gestational diabetes mellitus,330 combined with intrahepatic cholestasis of pregnancy,795 combined with oligohydramnios,5512 combined with anemia,30 combined with umbilical cord abnormalities,63 combined with placental abnormalities,331 combined with preeclampsia and 354 combined with fetal growth restriction.2.All the subjects were divided into the case group 354 cases and the control group18047 according to whether combined with fetal growth restriction.There was no significant difference in average age,average number of pregnancies,average number of births and types of parturients between the case group and the control group(P>0.05),and the average weight of newborns in the case group was significantly lower than that in the control group(P<0.05).3.The fasting blood glucose,early pregnancy PAPP-A,early pregnancy PLGF in the case group were significantly lower than those in the control group(P<0.05);the hematocrit of the case group was significantly higher than that in the control group(P<0.05).4.There was no significant difference in TPS levels between the case group and the control group in the early,middle and late pregnancy(P>0.05);there was no significant difference in FPS levels between the case group and the control group in the early and middle pregnancy(P>0.05),but there was no significant difference of the case group in pregnancy(P>0.05).The level of late FPS was significantly lower than the control group(t=4.639,P=0.014);there was no significant difference in PS activity between the case group and the control group in early pregnancy(P>0.05),while the PS activity of the case group in mid-pregnancy and late pregnancy was significantly lower than the control group(t=8.137,6.268,P=0.000,0.013).5.Complications of pregnancy hypertension,preeclampsia,intrahepatic cholestasis of pregnancy,oligohydramnios,anemia,placental abnormalities were significantly correlated with fetal growth restriction(P<0.05),while hypothyroidism,diabetes mellitus and older pregnancy were not correlated with fetal growth restriction(P>0.05).6.Intrahepatic cholestasis of pregnancy,oligohydramnios,anemia and abnormal placenta were the independent factors affecting fetal growth restriction.The risk of fetal growth restriction in patients with intrahepatic cholestasis of pregnancy was 1.948 times that in patients without intrahepatic cholestasis of pregnancy(95% CI:1.090 3.483);the risk of fetal growth restriction in patients with oligohydramnios was 4.046 times that in those without oligohydramnios(95%CI: 3.001 5.455).The risk of fetal growth restriction in patients with placental abnormalities was 11.581 times higher than that in those without placental abnormalities(95% CI:6.276 21.368);the risk of fetal growth restriction in anemia patients was 0.286 times higher than that in non-anemia patients(95% CI:0.202 0.405).7.The incidences of fetal distress,neonatal asphyxia and perinatal mortality in the case group were 45.76%(162/354),19.77%(70/354)and 3.11%(11/354)respectively higher than the control group 9.77%(1764/18047),3.27%(591/18047)and 0.05%(10/18047),with statistical significance(P<0.05).8.According to the mode of delivery,82 pregnant women with fetal growth restriction were divided into <2kg group,127 cases in 2.0-2.4kg group,45 cases in 2.4-2.5kg group.The ratio of 0-3 score to 4-7 score,asphyxia rate and neonatal mortality in <2kg group were significantly higher than those in 2.0-2.4kg group and 2.4-2.5kg group,respectively,with statistical significance(P<0.05),but the ratio of 0-3 score in 2.0-2.4kg group and 2.4-2.5kg group was significantly higher than that in <2kg group(P<0.05).There was no significant difference in the proportion of 4-7 points,neonatal asphyxia rate and neonatal mortality(P>0.05).Conclusion Gestational hypertension,preeclampsia,intrahepatic cholestasis,oligohydramnios,anemia and placental abnormalities are associated with fetal growth restriction.Intrahepatic cholestasis of pregnancy,oligohydramnios,anemia and placental abnormalities were independent risk factors for fetal growth restriction.These risk factors should be identified as early as possible,and timely and effective prevention and control measures should be taken to reduce the morbidity and mortality of perinatal infants.