目的 研究高危妊娠孕晚期脐动脉S/D值与胎儿综合生长发育情况的关系。方法 选择2013 年7月～2014年7月于我院产科治疗的40例妊娠期糖尿病孕妇（GDM组），63例妊娠期高血压孕妇 （HDP组）及73例无并发症和合并症的孕妇（对照组）。记录各组孕妇的年龄、孕周、平均动脉 压、孕35周后超声S/D值（妊娠晚期脐动脉收缩末期峰值/舒张末期峰值）、遗传病史及新生儿出 生5 min的阿氏评分、身高、体重、胸围及头围，并计算张路指数（ZLI）及劳尔指数（RI），比 较3组间上述数据的差异。结果 S/D值与ZLI及RI均呈负相关。GDM组和HDP组孕妇脐动脉血流S/ D值均较相同孕周的对照组高，且HDP组孕妇血压控制的高低对S/D值、ZLI及RI均有影响，妊娠 超过39周时S/D值有升高趋势，可能对胎儿及围产儿预后有不良影响。GDM组孕妇合并有糖尿病 家族遗传史及HDP组孕妇合并有高血压家族遗传史会进一步影响围产儿的生长情况。新生儿体格 发育参考标准中，ZLI较RI更能准确地评价新生儿的情况。高危妊娠孕妇在孕晚期（≥35周）是 否以S/D=2.5为警戒值还有待大量人群数据验证。结论 高危孕妇孕晚期脐动脉S/D值能反映胎儿宫 内生长情况，总的S/D值与新生儿体格发育指数ZLI、RI均有相关性，表明S/D值有一定的预后作 用，其中SD与ZLI的决定系数为SD与RI的一倍，表明ZLI与SD的相关程度较RI与SD更密切。因 此，高危孕妇的孕晚期脐动脉S/D值可用于指导临床评估终止妊娠时胎儿的综合生长发育情况。

Objective To study the relationship between third trimester umbilical artery S/D (Systolic/ Diastolic Ratio) value and fetal growth & development in high-risk pregnancy. Methods The study was conducted in the hospital from July 2013 to July 2014, including 40 patients with GDM (Gestational Diabetes Mellitus), 63 patients with HDP (Hypertension Disorder Complicating Pregnancy) and 73 pregnant women without complications (Control Group). The age, gestational weeks, MAP (Mean Arterial Pressure), third trimester S/D ratio, genetic tendency, body index, height, weight and head circumference of neonatus and the Neonatal Apgar score were recorded, and ZLI (Zhang Lu Index) and RI (Raul Index) were calculated for comparison between three groups. Results S/D value was negatively correlated with ZLI and RI. The umbilical artery blood S/D value of GDM Group and HDP Group were higher than that of Control Group with the same gestational weeks, and the control of blood pressure level in HDP Group affected S/D value, ZLI and RI. The increased S/D value for pregnancy more than 39 weeks might have adverse effects on fetal and perinatal prognosis. GDM Group with a family history of diabetes and HDP Group with a family history of high blood pressure would further affect the perinatal growth. In reference with the standards of neonatal physical development, ZLI was more accurate than RI in evaluating the condition of the newborn. Whether S/D=2.5 was taken as the warning value for high-risk pregnancy in late pregnancy (over 35 weeks) remained to be validated through a large number of data. Conclusion The late pregnancy umbilical artery S/D value of high-risk pregnant women reflected the fetal intrauterine growth. The neonatal body mass index, ZLI and RI were correlated with the total value of S/D, which showed that the S/D value had a certain role in prognosis. The coefficient of determination of SD and ZLI was two times of SD and RI, suggesting that ZLI and SD were more closely than RI and SD. Therefore, the umbilical artery S/D value of the pregnant women at high risk could be used to guide the clinical evaluation of fetal growth and development in the termination of pregnancy.