Table1_Observed to expected lung area to head circumference ratio (O/E LHR) in fetuses with congenital anomalies of the kidney and urinary tract (CAKUT): assessment and evaluation as predictive factor for acute postnatal outcome—a single center study.xlsx

IntroductionTo assess the observed to expected lung area to head circumference ratio (O/E LHR) in fetuses with congenital anomalies of the kidney and urinary tract (CAKUT) and to explore its value as a potential predictive factor for postnatal outcome.
MethodsA retrospective single-center study was conducted on pregnancies complicated by CAKUT between 2007 and 2018. The lung-to-head ratio (LHR) was calculated for each fetus by two independent observers. Correlations between O/E LHR and various perinatal outcome factors were assessed with Spearman's rank correlation. Furthermore, nominal logistic regression was performed to assess O/E LHR as predictive factor for respiratory distress in newborn.
ResultsOf 64 pregnancies complicated by CAKUT, 23 were terminated. In the 41 cases of continuation of pregnancy, newborn presenting respiratory distress with need for respiratory support in the delivery room showed earlier gestational age at onset of amniotic fluid abnormalities and at birth. Although median O/E LHR and median single deepest pocket (SDP) of amniotic fluid were significantly smaller in newborn that did develop respiratory distress with need of respiratory support in the delivery room, neither O/E LHR nor SDP were accurate predictors for the development of respiratory distress.
ConclusionsOur data show that O/E LHR alone cannot serve as a predictive marker for fetal outcome in pregnancies complicated by CAKUT, though it might still be a helpful parameter together with detailed renal ultrasound evaluation, onset of amniotic fluid abnormality and SDP, particularly in its extreme values.

引言
本研究旨在评估合并先天性肾和泌尿道畸形（congenital anomalies of the kidney and urinary tract, CAKUT）胎儿的肺面积与头围比值的观测值与预期值之比（observed to expected lung area to head circumference ratio, O/E LHR），并探讨其作为产后结局潜在预测因子的价值。

方法
本研究为单中心回顾性研究，纳入2007年至2018年间确诊合并CAKUT的妊娠病例。由2名独立观察者对每例胎儿的肺-头围比值（lung-to-head ratio, LHR）进行计算。采用Spearman秩相关分析评估O/E LHR与各项围产期结局指标的相关性。此外，通过名义Logistic回归分析，评估O/E LHR作为新生儿呼吸窘迫预测因子的效能。

结果
本研究共纳入64例合并CAKUT的妊娠病例，其中23例选择终止妊娠。剩余41例继续妊娠的病例中，需在产房接受呼吸支持的新生儿呼吸窘迫患儿，其羊水异常起病孕周及出生孕周均更早。尽管需在产房接受呼吸支持的呼吸窘迫新生儿的O/E LHR中位数及羊水最大最深池（single deepest pocket, SDP）中位数均显著更低，但O/E LHR与SDP均无法准确预测呼吸窘迫的发生。

结论
本研究数据显示，单独使用O/E LHR无法作为合并CAKUT妊娠的胎儿结局预测指标，但结合详细的肾脏超声评估、羊水异常起病时间及SDP，尤其是极端值情况下，O/E LHR仍可作为一项有价值的参考参数。