Su Y N, Lee C N, Cheng W F, Shau W Y, Chow S N, Hsieh F J
Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University, Taipei, Taiwan.
Obstet Gynecol. 2001 Jun;97(6):898-904. doi: 10.1016/s0029-7844(01)01341-2.
To compare early second-trimester maternal serum placenta growth factor concentrations in patients with subsequent development of preeclampsia and those with normal pregnancies.
We conducted a case-control analysis of stored maternal serum of 27 women who subsequently developed preeclampsia and 227 randomly selected normal controls during the gestational period of 14-19 weeks. Using such a sample size, there was a greater than 95% power to test a difference in the primary study interest. A quantitative sandwich enzyme immunoassay was used to measure the maternal serum placenta growth factor concentration. For statistical analysis, Mann-Whitney U tests, multiple linear regression analysis, multivariable logistic regression model, and receiver-operating characteristic (ROC) curve were used. P <.05 was considered statistically significant.
Maternal serum placenta growth factor concentration was associated with the occurrence of subsequent preeclampsia (P <.001) and gestational age (P <.001). The median (interquartile range) of multiples (MoM) of the gestational age stratified median for placenta growth factor in preeclampsia was 0.55 (0.33, 0.85). The ROC curve revealed that the specificity was 70% when the diagnostic sensitivity was 70%, and the optimal cutoff value of placenta growth factor MoM was 0.76. The risk of developing preeclampsia subsequently was increased 2.5-fold for maternal serum placenta growth factor concentration decrements of 0.1 MoM.
A decreased maternal serum placenta growth factor concentration in the early second trimester is highly associated with the subsequent development of preeclampsia, but a large prospective study is needed to explore its use as an early predictor for the condition.
比较孕中期子痫前期患者与正常妊娠患者孕早期血清胎盘生长因子浓度。
我们对27例随后发生子痫前期的孕妇和227例随机选择的正常对照孕妇在妊娠14 - 19周期间储存的母血清进行了病例对照分析。采用这样的样本量，有超过95%的把握度检验主要研究兴趣中的差异。采用定量夹心酶免疫测定法测量母血清胎盘生长因子浓度。进行统计分析时，使用了曼-惠特尼U检验、多元线性回归分析、多变量逻辑回归模型和受试者工作特征（ROC）曲线。P <.05被认为具有统计学意义。
母血清胎盘生长因子浓度与随后子痫前期的发生（P <.001）和孕周（P <.001）相关。子痫前期中胎盘生长因子按孕周分层中位数倍数（MoM）的中位数（四分位间距）为0.55（0.33，0.85）。ROC曲线显示，当诊断敏感性为70%时，特异性为70%，胎盘生长因子MoM的最佳截断值为0.76。母血清胎盘生长因子浓度每降低0.1 MoM，随后发生子痫前期的风险增加2.5倍。
孕中期早期母血清胎盘生长因子浓度降低与随后子痫前期的发生高度相关，但需要进行大规模前瞻性研究以探索其作为该疾病早期预测指标的用途。
