Objectives The aim of the study was to evaluate the effect of the brain-sparing effect (BSE) of fetal growth restriction (FGR) in newborn germinal matrix/intraventricular hemorrhage (GM/IVH). Methods A total of 320 patients who delivered prior to the 34th gestational week were analyzed from data records. 201 patients were divided into two groups according to cerebro-placental ratio (CPR): early fetal growth restriction (FGR) with abnormal CPR group (n=104) and appropriate for gestational age with normal Doppler group (control) (n=97). Using the normal middle cerebral artery (MCA) Doppler as a reference, multivariate logistic regression analysis was used to assess the association between the BSE and the primary outcome. Results The rate of Grade I–II germinal matrix/intraventricular hemorrhage (GM/IVH) was 31(29.8%) in the group possessing early FGR with abnormal CPR and 7(7.2%) in the control group, showing a statistically significant difference. The rate of grade III–IV GM/IVH was 7(6.7%) in the group possessing early FGR with abnormal CPR and 2 (2.1%) in the control group, showing no statistically significant difference. We found that gestational age at delivery <32 weeks was an independent risk factor for GM/IVH. In addition, we found that other variables such as the presence of preeclampsia, fetal weight percentile <10, emergency CS delivery, 48-h completion after the first steroid administration and 24-h completion rate after MgSO4 administration were not independently associated with the primary outcome. Conclusions Our results indicate that the rate of GM-IVH was increased in the group possessing early FGR with abnormal CPR; however, multivariate logistic regression analysis showed that BSE was not an independent risk factor for GM/IVH.

中文翻译：

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生长受限胎儿的保脑作用在新生儿生发基质/脑室内出血中的作用

目的 本研究的目的是评估胎儿生长受限 (FGR) 对新生儿生发基质/脑室内出血 (GM/IVH) 的保脑效应 (BSE) 的影响。方法从数据记录中分析320例孕34周前分娩的患者。201例患者按脑胎盘比（CPR）分为两组：早期胎儿生长受限（FGR）伴异常CPR组（n=104）和适合胎龄伴正常多普勒组（对照组）（n=97） . 使用正常大脑中动脉 (MCA) 多普勒作为参考，使用多变量逻辑回归分析来评估 BSE 与主要结果之间的关联。结果Ⅰ~Ⅱ级生发基质/脑室内出血（GM/IVH）发生率为31（29. 心肺复苏异常早期 FGR 组 8%)，对照组 7%(7.2%)，差异有统计学意义。早期FGR伴CPR异常组Ⅲ～Ⅳ级GM/IVH发生率为7例（6.7%），对照组为2例（2.1%），差异无统计学意义。我们发现分娩时胎龄<32 周是 GM/IVH 的独立危险因素。此外，我们发现其他变量，例如先兆子痫的存在、胎儿体重百分位数 <10、紧急 CS 分娩、第一次类固醇给药后 48 小时完成率和 MgSO 后 24 小时完成率 1%）在对照组中，差异无统计学意义。我们发现分娩时胎龄<32 周是 GM/IVH 的独立危险因素。此外，我们发现其他变量，例如先兆子痫的存在、胎儿体重百分位数 <10、紧急 CS 分娩、第一次类固醇给药后 48 小时完成率和 MgSO 后 24 小时完成率 1%）在对照组中，差异无统计学意义。我们发现分娩时胎龄<32 周是 GM/IVH 的独立危险因素。此外，我们发现其他变量，例如先兆子痫的存在、胎儿体重百分位数 <10、紧急 CS 分娩、第一次类固醇给药后 48 小时完成率和 MgSO 后 24 小时完成率4给药与主要结局无关。结论 我们的结果表明，早期 FGR 伴 CPR 异常组 GM-IVH 发生率增加；然而，多变量逻辑回归分析表明，BSE 不是 GM/IVH 的独立危险因素。