| 摘要: |
| 目的探索孕中期血清产前筛查指标的中位数倍数值（MoM值）异常与不良妊娠结局的相关性。方法回顾性分析宁波地区2012—2013年参加中孕期血清筛查、随访资料完整且结束妊娠的妇女121404例，并按妊娠结局分为不良结局组（1559例）与正常结局组（119845例），比较两组妇女孕中期血清甲胎蛋白（AFP）、游离β人绒毛膜促性腺激素（fβ-hCG）和游离雌三醇（uE3）的MoM值；并分析血清三联指标MoM值异常对不良妊娠结局的影响。结果不良结局组AFP、fβ-hCG的MoM值均高于正常结局组（均P＜0.05），uE3的MoM值低于正常结局组（P＜0.05）。AFP、fβ-hCG的MoM值异常升高，uE3的MoM值异常降低，三项筛查指标中MoM值单项、两项和三项异常者，其发生不良妊娠结局的风险均明显增加，其中三项异常者发生不良妊娠结局的风险最高（OR=33.23，95%CI：21.91~50.41）。结论孕中期血清AFP、fβ-hCG、uE3的MoM值出现单项、两项和三项异常均是发生不良妊娠结局的危险因素。建议对血清学筛查指标异常者进行目标疾病诊断外，还应重视其发生不良妊娠结局的可能。 |
| 关键词: 血清产前筛查 甲胎蛋白 游离 β 人绒毛膜促性腺激素 游离雌三醇 妊娠结局 |
| DOI： |
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| Relationship between second-trimester maternal serum triple screening markers and adverse pregnancy outcomes |
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Shen Qinqin, Zhang Tan
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Ningbo Women and Children's Hospital
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| Abstract: |
| Objective To investigate the correlation between abnormal multiples of median (MoM) of second-trimester maternal serum triple screening (STMSTS) markers and adverse pregnancy outcomes (APO). Methods The clinical data of
121 404 pregnant women who underwent STMSTS in 2012 and 2013 in Ningbo municipality were retrospectively analyzed. Alpha-fetoprotein (AFP), free β-subunit human chorionic gonadotropin (fβ-hCG) and unconjugated estriol (uE3) levels were converted to MoM. The normal range of three markers were classified as 0.7 ≤AFP MoM ≤2.0, 0.5 ≤fβ-hCG MoM ≤2.0, uE3 MoM≥0.5. The MoM of STMSTS markers were compared between women with APO and normal outcomes by using Chi-square
test or Fisher's exact test. Results Among 121404 pregnant women, there were 1559 cases of APO (group 1), 119845 cases of normal outcomes(group 2). The MoM of AFP and fβ-hCG in APO group was higher and that of uE3 was lower than those in normal outcome group (all P＜0.05). The risk of adverse outcomes were increased with number of MoM abnormality in three markers, the highest risk was seen in women with abnormal MoM of all three markers (OR=33.23, 95% CI:21.91~50.41). Conclusion The
elevated MoM of AFP, fβ-hCG and reduced MoM of uE3 in second-trimester are the risk factors for adverse pregnant outcome, suggesting that the abnormal marker may not only indicate the targeting disease, but also the possibility of adverse pregnant outcomes. |
| Key words: Prenatal maternal serum screening Alpha-fetoprotein Free β-subunit human chorionic gonadotropin
Unconjugated estriol Adverse pregnancy outcomes |
