元医生智能体/妇产/知识库
文献速递产科母胎医学

大脑中动脉多普勒与脑胎盘比对FGR神经结局的预测

Middle Cerebral Artery Doppler and Cerebroplacental Ratio Predict Adverse Neurological Outcomes in Fetal Growth Restriction.
PubMed 文献 · Prenat Diagn · 2026-05-28

本研究为回顾性队列研究，纳入2018-2019年单胎FGR妊娠，评估大脑中动脉（MCA）多普勒及脑胎盘比（CPR）对新生儿神经和呼吸结局的预测效能。结果显示MCA（OR 0.51，95%CI 0.32-0.82）和CPR（OR 1.36，95%CI 1.10-1.68）是神经结局的显著预测因子（p<0.05），多变量模型AUC达80.30%。

要点

  • MCA多普勒和CPR可预测FGR胎儿不良神经结局。
  • 多变量模型预测神经结局的AUC为80.30%。
  • 新生儿头围与MCA PI z-score的相关性仅见于单变量分析。

核心结论

  • MCA多普勒和CPR是FGR胎儿不良神经结局的有效预测因子，可能有助于临床风险分层。

研究设计与样本

  • 回顾性队列研究，纳入2018-2019年单胎FGR妊娠，收集MCA和CPR多普勒指数（z-score）及新生儿神经和呼吸结局。

主要发现

  • MCA（OR 0.51，95%CI 0.32-0.82）和CPR（OR 1.36，95%CI 1.10-1.68）是神经结局的显著预测因子（p<0.05）。
  • 孕龄和CPR的单变量准确性相当，但多变量模型表现更优，AUC为80.30%。
  • 单变量分析显示新生儿头围与MCA PI z-score显著相关，但多变量分析未证实。

临床怎么用

  • 临床可考虑使用MCA多普勒和CPR对FGR胎儿进行神经结局风险分层。

以上解读依据论文摘要（全文未开放获取或许可不允许翻译转载）。

原文

OBJECTIVE: To assess the efficacy of middle cerebral artery (MCA) Doppler ultrasonography in predicting neurological and respiratory outcomes in fetuses with fetal growth restriction (FGR) and to establish a correlation between MCA Doppler and head circumference (HC). METHOD: Retrospective cohort study examining singleton pregnancies affected by FGR (2018-2019). MCA and Cerebroplacental Ratio (CPR) Doppler indices (z-scores) alongside neonatal neurological and respiratory outcomes were gathered. RESULTS: MCA (OR 0.51, 95% CI 0.32-0.82) and CPR (OR 1.36, 95% CI 1.10-1.68) were identified as significant predictors of neurological outcomes (p < 0.05). Gestational age and CPR exhibited comparable univariate accuracy; however, the multivariate model demonstrated superior performance, achieving an area under the curve of 80.30%. Correlation analysis indicated a significant relationship between neonatal HC and MCA PI z-score in univariate analysis, but this was not confirmed in multivariate analysis. CONCLUSION: MCA Doppler and CPR are effective predictors of adverse neurological outcomes in FGR, potentially aiding risk stratification in clinical practice.

来源：Prenat Diagn，查看原文。版权归原作者所有。

引用

  1. Visentin S, Londero AP, Lo Storto G, et al. Middle Cerebral Artery Doppler and Cerebroplacental Ratio Predict Adverse Neurological Outcomes in Fetal Growth Restriction. Prenat Diagn. 2026. PMID: 42210428. doi:10.1002/pd.70189
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供执业医师工作参考，不替代临床判断；数值与分级以指南原文为准。