Analysis Of Clinical Factors Affecting The Prognosis Of Newborns With Selective Intrauterine Growth Restriction Under Expectant Management

Objective : Exploration is for the adverse outcome,prognosis and influencing factors of different types of selective intrauterine growth restriction newborns,so as to provide reference for the pregnancy health care and monitoring of sIUGR pregnant women and to improve neonatal outcome.Methods : The clinical data of 94 pregnant women with sIUGR in Shengjing Hospital affiliated to China Medical University from 2018 to 2022 were retrospectively analyzed,the pregnant woman’s age,whether their mothers were complicated with gestational hypertension or gestational diabetes,the classification of sIUGR,the gestational age when sIUGR was diagnosed,the ratio of estimated weight difference between big and small fetuses at diagnosis,the gestational age of delivery,Apgar score of 1min and 5 min after birth were collected.Umbilical artery blood gas PH value,neonatal nervous system injury,twin survival and other information,through the methods of single factor T test,variance analysis,multiple comparison and multivariate Logistic regression analysis to analyze the clinical characteristics of different types of sIUGR,and follow up the neonatal situation after delivery to explore the neonatal outcome and prognosis and its influencing factors.Results:The average gestational age of sIUGR Ⅱ was earlier than that of sIUGR type Ⅰ and sIUGR type Ⅲ(P< 0.001,P< 0.05),the average birth weight of sIUGR type Ⅰ was significantly higher than that of sIUGR type Ⅱ and sIUGR type Ⅲ(P<0.001,P< 0.05),and the average birth weight of sIUGR type Ⅰ was significantly higher than that of sIUGR type Ⅱ and sIUGR type Ⅲ(P< 0.001),the type of sIUGR type Ⅰ occurred in 1 case(5.88%),only one fetus died in the uterus,and didn’t have twins died case.In sIUGR type Ⅱ,5 cases(11.9%)had one fetus died in the uterus,and 3 cases(7.1%)had twins died in the uterus.0 cases(0%)of type Ⅲ fetal death occurred in uterus.The incidence of intrauterine fetal death of sIUGR type Ⅱ is the highest.Through univariate and multivariate logistic regression analysis on the influencing factors of intrauterine fetal death of type Ⅱ,it is concluded that there are differences in the EFW% of large and small fetuses at the gestational age and at the time of diagnosis,with statistical significance(P< 0.05).Conclusion :The classification of sIUGR is the most important factor affecting the prognosis of newborns,and type Ⅱ has the worst prognosis and is prone to intrauterine fetal death.The earlier the gestational age of sIUGR type Ⅱ is diagnosed,the greater the estimated weight difference ratio of the large and small fetuses at the time of diagnosis,and the higher the risk of intrauterine fetal death.Clinically,the cases diagnosed as sIUGR earlier need to be monitored more closely.This study looks forward to the management plan of treatment,which can better monitor the progress of the disease and terminate the pregnancy in time in order to improve the prognosis of newborns.