Predictors of Poor Perinatal Outcome following Maternal Perception of Reduced Fetal Movements – A Prospective Cohort Study 英文参考文献.docVIP

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Predictors of Poor Perinatal Outcome following Maternal Perception of Reduced Fetal Movements – A Prospective Cohort Study 英文参考文献.doc

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Predictors of Poor Perinatal Outcome following Maternal Perception of Reduced Fetal Movements – A Prospective Cohort Study 英文参考文献

PredictorsofPoorPerinatalOutcomefollowingMaternal PerceptionofReducedFetalMovements–AProspective CohortStudy PhilipJ.Dutton1,LynneK.Warrander1,StephenA.Roberts2,GiovannaBernatavicius3,LouiseM.Byrd3, DavidGaze4,JoshKroll1,RebeccaL.Jones1,ColinP.Sibley1,J.FrederikFr?en5,AlexanderE.P.Heazell1,3* 1MaternalandFetalHealthResearchCentre,ManchesterAcademicHealthScienceCentre,UniversityofManchester,Manchester,UnitedKingdom,2HealthSciences– Methodology, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom, 3Department of Obstetrics, St Mary’s Hospital, CentralManchesterUniversityHospitalsNHSFoundationTrust,Manchester,UnitedKingdom,4DepartmentofChemicalPathology,StGeorge’sHospitalMedicalSchool, London,UnitedKingdom,5DivisionofEpidemiology,NorwegianInstituteofPublicHealth,Oslo,Norway Abstract Background:Maternalperceptionofreducedfetalmovement(RFM)isassociatedwithincreasedriskofstillbirthandfetal growthrestriction(FGR).RFMisthoughttorepresentfetalcompensationtoconserveenergyduetoinsufficientoxygenand nutrienttransferresultingfromplacentalinsufficiency. Objective:Toidentifypredictorsofpoorperinataloutcomeaftermaternalperceptionofreducedfetalmovements(RFM). Design:Prospectivecohortstudy. Methods:305womenpresentingwithRFMafter28weeksofgestationwererecruited.Demographicfactorsandclinical historywererecordedandultrasoundperformedtoassessfetalbiometry,liquorvolumeandumbilicalarteryDoppler.A maternal serum sample was obtained for measurement of placentally-derived or modified proteins including: alpha fetoprotein (AFP), human chorionic gonadotrophin (hCG), human placental lactogen (hPL), ischaemia-modified albumin (IMA),pregnancyassociatedplasmaproteinA(PAPP-A)andprogesterone.Factorsrelatedtopoorperinataloutcomewere determinedbylogisticregression. Results:22.1%ofpregnanciesendedinapoorperinataloutcomeafterRFM.Themostcommoncomplicationwassmall-for- gestationalageinfants.PregnancyoutcomeaftermaternalperceptionofRFMwasrelatedtoamountoffetalact