Leiberman J R, Shoham I, Chattach F, Romem Y, Glezerman M
Division of Obstetrics and Gynecology, Soroka University Hospital, Faculty of Health Sciences, Ben Gurion University, Beer Sheva, Israel.
Am J Perinatol. 1992 Sep-Nov;9(5-6):319-21. doi: 10.1055/s-2007-999254.
Hypertensive disorders during pregnancy implicate placental pathologic conditions, which may interfere with the normal passage of alpha-fetoprotein (AFP) to the maternal blood. We compared the levels of maternal serum (MS) in early second trimester of pregnancies complicated by hypertensive disorders with those of matched controls. The distribution in the study group of MS-AFP multiple of median values was significantly different from the distribution in the control group. Moreover, up to multiple of the median 1.00, the number of hypertensive patients was larger than the number of normotensive pregnant women. The mean level of multiples of the median in the study group was significantly lower than that of the control group (p value = 0.003, 95% confidence interval: -0.30, -0.05). In the analysis of the distinct types of hypertension, the difference remained significant for 85 women in the moderate hypertension subgroup (p value = 0.032, confidence interval: -0.34, -0.02) and was not significant for the severe hypertension subgroup of 22 women (p value = 0.24, 95% confidence interval: -0.57, 0.15) and chronic hypertension subgroup of women (p value = 0.52, 95% confidence interval: -0.44, 0.00). The trend was consistent in all the subgroups. Relatively low values of maternal serum AFP at early second trimester of pregnancies with hypertensive disorders may be a result of placental pathologic involvement and can help in the identification of the women at risk.
妊娠期高血压疾病与胎盘病理状况有关，这可能会干扰甲胎蛋白（AFP）向母体血液的正常传递。我们比较了患有高血压疾病的妊娠中期孕妇与匹配对照组孕妇血清中甲胎蛋白（MS-AFP）的水平。研究组中MS-AFP中位数倍数的分布与对照组显著不同。此外，在中位数倍数达到1.00时，高血压患者的数量多于血压正常的孕妇。研究组中位数倍数的平均水平显著低于对照组（p值 = 0.003，95%置信区间：-0.30，-0.05）。在对不同类型高血压的分析中，中度高血压亚组中的85名女性差异仍然显著（p值 = 0.032，置信区间：-0.34，-0.02），而重度高血压亚组中的22名女性差异不显著（p值 = 0.24，95%置信区间：-0.57，0.15），慢性高血压亚组中的女性差异也不显著（p值 = 0.52，95%置信区间：-0.44，0.00）。所有亚组的趋势一致。患有高血压疾病的妊娠中期孕妇血清AFP值相对较低可能是胎盘病理受累的结果，有助于识别有风险的女性。
