宫颈阴道分泌物中的β-人绒毛膜促性腺激素与早产

Beta-human chorionic gonadotropin in cervicovaginal secretions and preterm delivery.

作者信息

Garshasbi A, Ghazanfari T, Faghih Zadeh S

机构信息

Department of Obstetrics and Gynecology, Shahed University, Faculty of Medicine, Tehran, Iran.

出版信息

Int J Gynaecol Obstet. 2004 Sep;86(3):358-64. doi: 10.1016/j.ijgo.2004.05.006.

DOI:10.1016/j.ijgo.2004.05.006

PMID:15325853

Abstract

OBJECTIVES

To determine whether concentrations of beta-HCG in cervicovaginal secretions could predict spontaneous preterm birth (SPB) in asymptomatic high risk pregnancies.

METHODS

A cohort study was undertaken with cervicovaginal samples collected from 540 pregnant women between 20 to 28 weeks of gestation. Levels of beta-HCG were measured by ELISA test.

RESULTS

There was 3.2-fold increase in cervicovaginal beta-HCG concentrations among patients with SPB vs. term delivery. A single cervicovaginal beta-HCG > 77.8 mIU/ml, between 20 and 28 weeks' gestation, identified patients with subsequent SPB vs. term delivery with sensitivity of 87.5% (95% CI: 47.4-97.9) and a specificity of 97% (95% CI: 86.5-99.4) with positive and negative predictive values of 88.5% and 98%, respectively. Multiple logistic regression indicates that cervicovaginal beta-HCG level > 77.8 mIU/ml was an independent predictor of SPB (adjusted odds ratio 19.97, 95% CI: 10.65-37.45).

CONCLUSIONS

Cervicovaginal beta-HCG is a sensitive and specific predictor of patients with subsequent preterm delivery.

摘要

目的

确定宫颈阴道分泌物中β-HCG的浓度是否能够预测无症状高危妊娠中的自发性早产（SPB）。

方法

进行了一项队列研究，收集了540名妊娠20至28周孕妇的宫颈阴道样本。通过ELISA检测法测量β-HCG水平。

结果

与足月分娩的患者相比，SPB患者的宫颈阴道β-HCG浓度增加了3.2倍。在妊娠20至28周期间，单次宫颈阴道β-HCG>77.8 mIU/ml可识别出随后发生SPB与足月分娩的患者，其敏感性为87.5%（95%CI：47.4-97.9），特异性为97%（95%CI：86.5-99.4），阳性预测值和阴性预测值分别为88.5%和98%。多因素逻辑回归表明，宫颈阴道β-HCG水平>77.8 mIU/ml是SPB的独立预测因素（调整后的优势比为19.97，95%CI：10.65-37.45）。