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孕早期唐氏综合征联合筛查:非选择性孕妇队列中低出生体重、小于胎龄儿和早产的预测

First-trimester combined screening for Down syndrome: prediction of low birth weight, small for gestational age and pre-term delivery in a cohort of non-selected women.

作者信息

Pihl Kasper, Sørensen Tina Lindvig, Nørgaard-Pedersen Bent, Larsen Severin Olesen, Nguyen Tri Huu, Krebs Lone, Larsen Torben, Christiansen Michael

机构信息

Department of Gynaecology and Obstetrics, Holbaek Hospital, Holbaek, Denmark. Kasper

出版信息

Prenat Diagn. 2008 Mar;28(3):247-53. doi: 10.1002/pd.1946.

Abstract

OBJECTIVE

To establish the relationship between the first-trimester screening markers [pregnancy-associated plasma protein A (PAPP-A), free human chorionic gonadotrophin-beta (beta-hCG), nuchal translucency (NT)], the Down syndrome (DS) risk estimate, and the adverse outcomes such as low birth weight, small for gestational age (SGA) and pre-term delivery.

METHODS

A retrospective cohort study including 1,734 non-selected singleton pregnancies consecutively enrolled into the programme of first-trimester combined screening for DS in a 12-month period at a single centre. Data from the Prenatal Patient Registry in ASTRAIA were combined with the Danish National Newborn Screening Registry and Danish Birth Registry.

RESULTS

There was a significant relation between low PAPP-A MoM, low beta-hCG MoM, increased risk estimate for DS and low birth weight and SGA. Low PAPP-A MoM and increased NT showed a significant relation to pre-term and spontaneous pre-term delivery. Low PAPP-A MoM showed a significant relation to early pre-term delivery.

CONCLUSION

First-trimester screening markers exhibited a significant relation to low birth weight, SGA and to some extent, to pre-term and early pre-term delivery. The screening performance of individual markers was poor.

摘要

目的

建立孕早期筛查标志物[妊娠相关血浆蛋白A(PAPP-A)、游离人绒毛膜促性腺激素β(β-hCG)、颈项透明层(NT)]、唐氏综合征(DS)风险评估与低出生体重、小于胎龄儿(SGA)和早产等不良结局之间的关系。

方法

一项回顾性队列研究,纳入12个月内在单一中心连续参加DS孕早期联合筛查项目的1734例未经选择的单胎妊娠。将ASTRAIA产前患者登记处的数据与丹麦国家新生儿筛查登记处和丹麦出生登记处的数据相结合。

结果

低PAPP-A中位数倍数(MoM)、低β-hCG MoM、DS风险评估增加与低出生体重和SGA之间存在显著关系。低PAPP-A MoM和NT增加与早产和自发早产存在显著关系。低PAPP-A MoM与早期早产存在显著关系。

结论

孕早期筛查标志物与低出生体重、SGA以及在一定程度上与早产和早期早产存在显著关系。单个标志物的筛查性能较差。

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