She Bo-Quing, Chen Su-Chee, Lee Fa-Kung, Cheong Mei-Leng, Tsai Ming-Song
Department of Obstetrics and Gynecology, Cathay General Hospital, Taipei, Taiwan.
Taiwan J Obstet Gynecol. 2007 Sep;46(3):242-7. doi: 10.1016/S1028-4559(08)60027-3.
To assess the relationship between the first-trimester maternal serum pregnancy-associated plasma protein-A (PAPP-A) levels and pregnancies complicated by preterm delivery.
The correlation between PAPP-A levels and gestational age at delivery was analyzed by linear regression. The probabilities of low PAPP-A multiples of the median (MoM) levels between preterm delivery and control population were analyzed by logit model.
A positive correlation was noted between the first-trimester PAPP-A MoM levels and gestational age at delivery between 34-38 weeks (p < 0.001). Lower PAPP-A MoM level had a significantly higher likelihood of preterm delivery (p < 0.05). When preterm premature rupture of membranes (PPROM) and preterm labor (PTL) were analyzed separately, there was an increasing likelihood of PPROM with decreasing PAPP-A MoM levels (p < 0.05), but not for PTL with intact membranes.
Low maternal serum PAPP-A levels during the first trimester may reflect a trophoblast invasion defect in the maternal-fetal interface, resulting in subsequent preterm delivery, particularly in those of PPROM.
评估孕早期孕妇血清妊娠相关血浆蛋白-A（PAPP-A）水平与早产合并妊娠之间的关系。
采用线性回归分析PAPP-A水平与分娩孕周之间的相关性。采用logit模型分析早产组与对照组人群中PAPP-A中位数倍数（MoM）水平偏低的概率。
孕早期PAPP-A MoM水平与34 - 38周分娩孕周之间呈正相关（p < 0.001）。PAPP-A MoM水平较低者早产的可能性显著更高（p < 0.05）。当分别分析胎膜早破早产（PPROM）和早产临产（PTL）时，PPROM发生的可能性随PAPP-A MoM水平降低而增加（p < 0.05），但胎膜完整的PTL情况并非如此。
孕早期孕妇血清PAPP-A水平较低可能反映母胎界面滋养层侵入缺陷，从而导致随后的早产，尤其是PPROM情况。
