估计胎儿体重不一致在预测单绒毛膜双胞胎出生体重不一致中的诊断准确性：一项回顾性队列研究。

IF 2.7 2区医学 Q2 GENETICS & HEREDITY

Prenatal Diagnosis Pub Date : 2025-08-16 DOI:10.1002/pd.6873

Jip A Spekman, E J T Joanne Verweij, Femke Slaghekke, Monique C Haak, Chiara C M M Lap, Derek P de Winter, Jeanine M M van Klink, Enrico Lopriore, Sophie G Groene

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引用次数: 0

摘要

目的：评价超声估计胎儿体重不一致(EFWD)≥20%对单绒毛膜（MC）双胎妊娠出生体重不一致(BWD)≥20%（即选择性胎儿生长受限[sFGR]）的诊断准确性。方法：回顾性队列研究，纳入本中心大约2002年和2023年出生14天内可用超声的无并发症MC双胞胎（n = 213）和合并sFGR的MC双胞胎（n = 134）。在出生14天和7天内，我们计算敏感性和特异性。在出生3天内有超声的双胞胎亚组中，计算BWD的绝对误差（BWD- efwd）。结果：出生14天内EFWD≥20%预测BWD≥20%的敏感性和特异性分别为84% （95% CI 76-89）和85% （95% CI 79-89）。出生7天内超声检查（n = 192/347）显示出相当的诊断准确性（敏感性85% [95% CI 75-92]，特异性81% [95% CI 73-88]）。在出生3天内可获得超声的双胞胎中（n = 90/347），出生腰围的绝对误差为-2.0% (SD 8.0)，表明出生腰围的平均高估。结论：在合并sFGR的MC双胞胎中，超声EFWD≥20%预测BWD≥20%的准确率较高。出生后3天内的出生体重平均被高估了两个百分点。

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Diagnostic Accuracy of Estimated Fetal Weight Discordance in Predicting Birthweight Discordance in Monochorionic Twins: A Retrospective Cohort Study.

Objective: To evaluate the diagnostic accuracy of sonographic estimated fetal weight discordance (EFWD) ≥ 20% in predicting birthweight discordance (BWD) ≥ 20% (i.e., selective fetal growth restriction [sFGR]) in monochorionic (MC) twin pregnancies.

Method: Retrospective cohort study including uncomplicated MC twin pairs (n = 213) and MC twins with sFGR (n = 134), with available ultrasound within 14 days of birth approximately 2002 and 2023 in our center. Within 14 and 7 days of birth, we calculated sensitivity and specificity. In a subgroup of twins with available ultrasound within 3 days of birth, the absolute error of BWD was calculated (BWD-EFWD).

Results: The sensitivity and specificity of EFWD ≥ 20% within 14 days of birth in predicting BWD ≥ 20% were 84% (95% CI 76-89) and 85% (95% CI 79-89), respectively. Ultrasounds available within 7 days of birth (n = 192/347) showed comparable diagnostic accuracies (sensitivity 85% [95% CI 75-92], and specificity 81% [95% CI 73-88]). Among twins with available ultrasound within 3 days of birth (n = 90/347), the absolute error of BWD was -2.0% (SD 8.0), indicating a mean overestimation of BWD.

Conclusion: In MC twins with sFGR, the accuracy of sonographic EFWD ≥ 20% in predicting BWD ≥ 20%, is relatively high. BWD is overestimated by an average of two percentage points within 3 days of birth.

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来源期刊

Prenatal Diagnosis 医学-妇产科学

CiteScore

5.80

自引率

13.30%

发文量

204

审稿时长

2 months

期刊介绍： Prenatal Diagnosis welcomes submissions in all aspects of prenatal diagnosis with a particular focus on areas in which molecular biology and genetics interface with prenatal care and therapy, encompassing: all aspects of fetal imaging, including sonography and magnetic resonance imaging; prenatal cytogenetics, including molecular studies and array CGH; prenatal screening studies; fetal cells and cell-free nucleic acids in maternal blood and other fluids; preimplantation genetic diagnosis (PGD); prenatal diagnosis of single gene disorders, including metabolic disorders; fetal therapy; fetal and placental development and pathology; development and evaluation of laboratory services for prenatal diagnosis; psychosocial, legal, ethical and economic aspects of prenatal diagnosis; prenatal genetic counseling