超声指标和血液指标预测胎儿生长受限的研究现状

doi:10.3969/j.issn.1674-8115.2025.08.014

摘要/Abstract

摘要：

胎儿生长受限是指胎儿未能达到其遗传潜能所决定的生长潜力水平，是一种常见的妊娠并发症，发生率占妊娠的5%~10%。作为围产期死亡和不良新生儿结局的主要危险因素，胎儿生长受限的早期预测对优化妊娠管理至关重要。现有证据表明，胎儿生长受限与多种妊娠不良结局显著相关，包括宫内缺氧、早产、新生儿窒息乃至新生儿死亡等，还可能影响远期神经系统发育并增加成年期代谢性疾病风险。其发病机制复杂，可能涉及胎盘血流灌注不足及遗传因素等。超声指标是目前诊断胎儿生长受限的主要依据，其中胎儿生物学参数和血流动力学参数具有重要价值。脐动脉血流阻力指数升高、舒张末期血流缺失或反向以及胎盘功能不全与胎儿生长受限严重程度显著相关。然而，约10%超声诊断为胎儿生长受限的胎儿出生后证实为健康小样儿，该假阳性结果可能导致了不必要的临床干预。目前临床尚缺乏公认的胎儿生长受限预测模型，未来研究应致力于建立统一的诊断标准，开发基于人工智能的多指标联合预测工具。早期预测和干预胎儿生长受限对改善围产儿预后有重要意义。该文综述了超声指标、血液指标，及其与人工智能技术整合对胎儿生长受限的预测价值，以期为临床决策提供依据。

关键词: 胎儿生长受限, 超声指标, 血液指标, 人工智能, 预测

Abstract:

Fetal growth restriction (FGR) refers to the failure of a fetus to reach the level of growth potential determined by its genetic potential. It is a common obstetric complication, occurring in 5% to 10% of pregnancies. As a major risk factor for perinatal death and adverse neonatal outcomes, early prediction of FGR is crucial for optimizing pregnancy management. Existing evidence suggests that FGR is significantly associated with a variety of adverse pregnancy outcomes, including intrauterine hypoxia, preterm birth, neonatal asphyxia, and even neonatal mortality. It may also affect long-term neurological development and increase the risk of metabolic diseases in adulthood. Its pathogenesis is complex, which may involve placental blood flow perfusion insufficiency and genetic factors. Ultrasound parameters are the main basis for the diagnosis of FGR, among which fetal biological and hemodynamic parameters are of great value. Elevated umbilical artery blood flow resistance index, absent or reversed end-diastolic blood flow, and placental insufficiency are associated with the severity of FGR. However, approximately 10% of fetuses diagnosed by ultrasound as having FGR are later confirmed to be healthy small-for-gestational-age (SGA) infants after birth, and this false positive result may lead to unnecessary clinical interventions. Currently, there is no recognized accurate prediction model for FGR in clinical practice. Future research should focus on establishing unified diagnostic criteria and developing multi-index joint prediction tools based on artificial intelligence (AI). Early prediction and intervention for FGR are of great significance to improve perinatal outcomes. This paper reviewed the predictive value of ultrasound parameters, blood indicators, and their integration with AI for FGR, in order to provide a basis for clinical decision-making.

Key words: fetal growth restriction (FGR), ultrasound parameter, blood indicator, artificial intelligence (AI), prediction

中图分类号:

R714.51

梁书源, 叶宝英, 程蔚蔚. 超声指标和血液指标预测胎儿生长受限的研究现状[J]. 上海交通大学学报（医学版）, 2025, 45(8): 1059-1065.

LIANG Shuyuan, YE Baoying, CHENG Weiwei. Research status of ultrasound parameters and blood indicators in predicting fetal growth restriction[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2025, 45(8): 1059-1065.

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