非洲妊娠队列中脐动脉、大脑中动脉和腹主动脉降支的性别特异性多普勒模式
Sex-Specific Doppler Patterns of the Umbilical Artery, Middle Cerebral Artery, and Descending Abdominal Aorta in an African Pregnancy Cohort.
摘要(中文译文)
胎儿性别日益被认为是可能影响胎盘发育、胎儿循环及妊娠结局的生物学变量。然而，非洲人群中的性别特异性胎儿多普勒数据有限。本研究评估了加纳妊娠队列中脐动脉（UA）、大脑中动脉（MCA）和降主动脉（DA）的多普勒指标是否因胎儿性别而异。在加纳AngloGold Ashanti健康基金会接受产前保健的239例低危单胎妊娠中开展了一项前瞻性横断面研究。采用标准化超声方案获取胎儿生物测量、估计胎儿体重、胎心率以及UA、MCA和DA的多普勒血流速度测定。胎儿性别于产前确定并于分娩后确认。使用独立样本t检验或Mann-Whitney U检验比较男性和女性胎儿之间的多普勒指标（总体及按孕龄分层：≤25周、26-35周和>35周），统计学显著性设定为p < 0.05。男性胎儿占队列的53.6%（128/239），女性胎儿占46.4%（111/239）。当汇总所有孕龄时，UA、MCA和DA多普勒指标在胎儿性别间无显著差异。然而，在孕龄≤25周时观察到性别特异性模式。女性胎儿具有较高的UA搏动指数（p = 0.023）、阻力指数（p = 0.037）和收缩期/舒张期比值（p = 0.023），提示早期胎盘-胎儿阻抗较高。相反，男性胎儿具有较高的DA搏动指数（p = 0.048）和阻力指数（p = 0.015），提示早期全身血管阻力较高。在26至35周之间及35周之后，大多数多普勒差异无统计学显著性。男性胎儿在35周后具有较高的胎心率（144 ± 8.67 vs 140 ± 8.92次/分，p = 0.035）。在该加纳队列中，胎儿性别与UA、MCA或DA多普勒指标的总体显著差异无关，但在妊娠早期观察到孕龄特异性差异。女性胎儿显示较高的早期UA阻抗，而男性胎儿显示较高的早期DA阻抗及妊娠晚期较高的胎心率。这些发现支持在基于多普勒的胎儿监测中将胎儿性别视为生物学变量，并强调需要在非洲队列中建立人群特异性参考数据。
Abstract
Fetal sex is increasingly recognized as a biological variable that may influence placental development, fetal circulation, and pregnancy outcomes. However, sex-specific fetal Doppler data are limited in African populations. This study assessed whether Doppler indices of the umbilical artery (UA), middle cerebral artery (MCA), and descending abdominal aorta (DA) differ by fetal sex in a Ghanaian pregnancy cohort. A prospective cross-sectional study was conducted among 239 low-risk singleton pregnancies attending antenatal care at the AngloGold Ashanti Health Foundation in Ghana. Fetal biometry, estimated fetal weight, fetal heart rate, and Doppler velocimetry of the UA, MCA, and DA were obtained using standardized ultrasound protocols. Fetal sex was determined antenatally and confirmed after delivery. Doppler indices were compared between male and female fetuses overall and after stratification by gestational age (≤25, 26-35, and >35 weeks) using independent-samples t-tests or Mann-Whitney U tests, with statistical significance set at p < 0.05. Male fetuses accounted for 53.6% (128/239) of the cohort, whereas female fetuses accounted for 46.4% (111/239). When all gestational ages were pooled, UA, MCA, and DA Doppler indices did not differ significantly by fetal sex. However, sex-specific patterns were observed at ≤25 weeks of gestation. Female fetuses had higher UA pulsatility index (p = 0.023), resistive index (p = 0.037), and systolic/diastolic ratio (p = 0.023), suggesting higher early fetoplacental impedance. In contrast, male fetuses had higher DA pulsatility index (p = 0.048) and resistive index (p = 0.015), suggesting higher early systemic vascular resistance. Between 26 and 35 weeks and after 35 weeks, most Doppler differences were not statistically significant. Male fetuses had higher fetal heart rates after 35 weeks (144 ± 8.67 vs 140 ± 8.92 bpm, p = 0.035). In this Ghanaian cohort, fetal sex was not associated with significant overall differences in UA, MCA, or DA Doppler indices, but gestational age-specific differences were observed in early pregnancy. Female fetuses showed higher early UA impedance, whereas male fetuses showed higher early DA impedance and higher fetal heart rates in late gestation. These findings support consideration of fetal sex as a biological variable in Doppler-based fetal surveillance and highlight the need for population-specific reference data in African cohorts.
如何引用
AMA
Eric Ofori, Ijeoma C Anyitey-Kokor, Andrew Donkor, Prince N Adotey, Yaw A Wiafe. Sex-Specific Doppler Patterns of the Umbilical Artery, Middle Cerebral Artery, and Descending Abdominal Aorta in an African Pregnancy Cohort.. Cureus. 2026; doi:10.7759/cureus.110982.
APA
Eric Ofori, Ijeoma C Anyitey-Kokor, Andrew Donkor, Prince N Adotey, Yaw A Wiafe (2026). Sex-Specific Doppler Patterns of the Umbilical Artery, Middle Cerebral Artery, and Descending Abdominal Aorta in an African Pregnancy Cohort.. Cureus. https://doi.org/10.7759/cureus.110982
GB/T 7714
Eric Ofori, Ijeoma C Anyitey-Kokor, Andrew Donkor, Prince N Adotey, Yaw A Wiafe. Sex-Specific Doppler Patterns of the Umbilical Artery, Middle Cerebral Artery, and Descending Abdominal Aorta in an African Pregnancy Cohort.[J]. Cureus, 2026 doi:10.7759/cureus.110982.
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