Plevyak Michael P, Lambert-Messerlian Geralyn M, Farina Antonio, Groome Nigel P, Canick Jacob A, Silver Helayne M
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Brown University, Providence, Rhode Island, USA.
J Soc Gynecol Investig. 2003 May;10(4):231-6. doi: 10.1016/s1071-5576(03)00047-9.
To compare maternal serum levels of total activin A and inhibin A in preterm and term patients who are in labor or not in labor.
A cross-sectional study compared activin A and inhibin A in the following groups of patients: preterm and in labor (n = 65), preterm and not in labor (n = 96), term and in labor (n = 65), and term and not in labor (n = 65). Preterm was defined as 23-34 weeks' gestation and term as 37-42 weeks' gestation. Labor was defined as regular contractions with progressive cervical change or an initial examination revealing cervical dilation of 1-3 cm with 50% effacement or more. Follistatin levels were analyzed in a subset of 12 patients from each group. Analytes were measured by two-site enzyme-linked immunosorbent assays.
Activin A levels were higher in the preterm labor group (median 1.38 multiples of the median [MoM], interquartile range [IQR] 1.01 MoM) compared with the preterm nonlabor group (median 1.0 MoM, IQR 0.78 MoM, P <.05) and in the term labor group (median 1.37 MoM, IQR 1.74 MoM) compared with the term nonlabor group (median 1.0 MoM, IQR 0.87 MoM, P <.05). Inhibin A levels were higher in the preterm labor group (median 1.27 MoM, IQR 0.73 MoM) compared with the preterm nonlabor group (median 1.0 MoM, IQR 0.58 MoM, P <.05). Post-hoc analysis of activin A and inhibin A elevations in the preterm labor group revealed a significant effect only during 31-34 weeks' gestation. The total activin A:follistatin ratio, an indirect measure of free activin A, was similar between labor and nonlabor gestational age-matched patient groups.
Levels of total activin A and inhibin A were increased in patients during labor; however, based on the moderate degree and narrow gestational age range of the increased levels, these analytes are not likely to be clinically useful in predicting preterm labor.
比较临产和未临产的早产及足月患者母体血清中总激活素A和抑制素A的水平。
一项横断面研究比较了以下几组患者的激活素A和抑制素A水平：早产且临产（n = 65）、早产且未临产（n = 96）、足月且临产（n = 65）以及足月且未临产（n = 65）。早产定义为妊娠23 - 34周，足月定义为妊娠37 - 42周。临产定义为有规律宫缩且宫颈进行性改变，或初次检查发现宫颈扩张1 - 3 cm且宫颈管消退50%或更多。对每组中的12例患者亚组分析卵泡抑素水平。分析物采用双位点酶联免疫吸附测定法测量。
与早产未临产组（中位数1.0 MoM，四分位间距[IQR] 0.78 MoM，P <.05）相比，早产临产组的激活素A水平更高（中位数1.38倍中位数[MoM]，IQR 1.01 MoM）；与足月未临产组（中位数1.0 MoM，IQR 0.87 MoM，P <.05）相比，足月临产组的激活素A水平也更高（中位数1.37 MoM，IQR 1.74 MoM）。与早产未临产组（中位数1.0 MoM，IQR 0.58 MoM，P <.05）相比，早产临产组的抑制素A水平更高（中位数1.27 MoM，IQR 0.73 MoM）。对早产临产组激活素A和抑制素A升高情况的事后分析显示，仅在妊娠31 - 34周时有显著影响。总激活素A与卵泡抑素的比值（游离激活素A的间接指标）在临产和未临产的孕周匹配患者组之间相似。
临产患者的总激活素A和抑制素A水平升高；然而，基于升高水平的程度适中且孕周范围较窄，这些分析物在预测早产方面可能在临床上并无用处。
