Faktori udruženi sa feto-embrionalnim zastojem u rastu ploda
Factors associated with feto-embryonic growth restriction
Докторанд
Milosavljević, JovanaМентор
Živanović-Mačužić, IvanaЧланови комисије
Janković, SlobodanSazdanović, Predrag
Vulović, Maja
Nedin-Ranković, Gorana
Метаподаци
Приказ свих података о дисертацијиСажетак
Uvod: Uprkos razvoju ultrazvučnih metoda koje se mogu koristiti za rano otkrivanje
zastoja u rastu ploda (Fetal Growth Restriction- FGR), intrauterini FGR ostaje
neprepoznat do rođenja u većini slučajeva. Cilj ovog istraživanja je bio da se
identifikuju faktori rizika koji doprinose pojavi FGR-a u trudnoći i rađanju
novorođenčadi koja su mala za gestacijsku starost (Small for Gestational Age- SGA).
Materijal i metod: Istraživanje je dizajnirano kao bidirekcionalna kohortna
studija koja je sprovedena na populaciji trudnica koje su praćene i kontrolisane u
okviru Klinike za ginekologiju i akušerstvo Univerzitetskog kliničkog centra
Kragujevac. Stepen intrauterusnog razvoja ploda je procenjivan izračunavanjem
procenjene telesne težine fetusa (Estimated Fetal Weight- EFW) pomoću ultrazvučno
izmerenih anatomskih parametara rasta fetusa. Fetusi čija EFW se nalazila ispod
10-og centila na grafikonu rasta prilagođenom za pol i gestacijsku starost bili su
označeni kao FGR, dok su nov...orođenčad čija je telesna težina na rođenju bila ispod
10-og centila smatrana za SGA.
Rezultati: Faktori rizika za pojavu FGR-a ili SGA bili su manja telesna visina
majke (FGR u drugom i trećem trimestru i SGA), manja životna starost majke (FGR u
drugom trimestru), pušenje u toku trudnoće (FGR u trećem trimestru i SGA),
proteinurija u trudnoći (FGR u drugom i trećem trimestru i SGA) i upotreba
kortikosteroida u trudnoći (SGA), dok je suplementacija gvožđem imala protektivno
dejstvo na pojavu FGR-a u trećem trimestru trudnoće.
Zaključak: Identifikovani faktori rizika mogu biti implementirani u kliničku
praksu kao važan dopunski element skrininga za pojavu zastoja u rastu ploda u
trudnoći.
Introduction: Despite the development of ultrasound methods that can be used for early
detection of fetal growth restriction (FGR), intrauterine FGR remains unrecognized until birth
in most cases. The aim of this research was to identify risk factors that contribute to the
occurrence of FGR during pregnancy and the birth of infants who are small for gestational age
(SGA).
Material and methods: The research was designed as a bidirectional cohort study that was
conducted on the population of pregnant women who were monitored and controlled within
the Clinic for Gynecology and Obstetrics of the University Clinical Center Kragujevac. The
degree of intrauterine fetal development was assessed by calculating the estimated fetal body
weight (EFW) using ultrasound-measured anatomical parameters of fetal growth. Fetuses
whose EFW was below the 10th percentile on thе fetal growth chart adjusted for gender and
gestational age were classified as FGR fetuses, while newborns weighing less th...an the 10th
percentile were considered SGA.
Results: Significant risk factors associated with FGR or SGA in our study were lower
maternal body height (FGR during the second and third trimesters and SGA), younger
maternal age (FGR during the second trimester), smoking during pregnancy (FGR during the
third trimester and SGA), proteinuria in pregnancy (FGR during the second and third
trimesters and SGA) and use of corticosteroids in pregnancy (SGA), while iron
supplementation was a protective factor for the occurrence of FGR during the third trimester
of pregnancy.
Conclusion: Identified risk factors can be implemented in clinical practice as an important
additional element of screening for FGR during pregnancy.