Kang Jin Hee, Farina Antonio, Park Ji Hyeon, Kim Sung Han, Kim Ji Yeon, Rizzo Nicola, Elmakky Amira, Jun Hye Sun, Hahn Won Bo, Cha Dong Hyun
Department of Obstetrics and Gynecology, CHA General Hospital, Pochon CHA University College of Medicine, Seoul, Korea.
Prenat Diagn. 2008 Aug;28(8):704-9. doi: 10.1002/pd.1997.
To estimate the combined screening performance of first and early second trimester prenatal serum markers for Down syndrome, in screening for the development of preeclampsia, and analyze the correlation among marker levels, week of onset, and severity of the disease.
A retrospective cohort study was carried out on 32 women with preeclampsia and 3044 controls. Serum samples from these pregnancies were assayed for pregnancy-associated plasma protein-A (PAPP-A), alpha-fetoprotein (AFP), unconjugated estriol (uE3), human chorionic gonadotrophin (hCG), and inhibin-A. A likelihood ratio and the odds of being affected given a positive result (OAPR) of various combinations of markers were calculated and receiver operating characteristic (ROC) curves analysis was performed.
In the pregnancies that subsequently developed preeclampsia, first trimester PAPP-A concentration was significantly lower and concentrations of early second trimester inhibin-A and hCG significantly elevated. Levels of early second trimester uE3 and AFP were not significantly altered. We also found that inhibin-A correlates with both onset of the disease and the severity.
Down syndrome biochemical markers levels are altered in those patients who subsequently developed preeclampsia and may be a useful screening test for preeclampsia. Inhibin-A is the most predictive marker and correlates with the severity of subsequent preeclampsia and inversely with the week of occurrence of preeclampsia.
评估孕早期和孕中期早期产前血清标志物联合筛查唐氏综合征的性能，筛查子痫前期的发生情况，并分析标志物水平、发病孕周与疾病严重程度之间的相关性。
对32例子痫前期患者和3044例对照进行回顾性队列研究。检测这些孕妇血清样本中的妊娠相关血浆蛋白-A（PAPP-A）、甲胎蛋白（AFP）、游离雌三醇（uE3）、人绒毛膜促性腺激素（hCG）和抑制素-A。计算各种标志物组合的似然比和阳性结果时受影响的概率（OAPR），并进行受试者工作特征（ROC）曲线分析。
在随后发生子痫前期的妊娠中，孕早期PAPP-A浓度显著降低，孕中期早期抑制素-A和hCG浓度显著升高。孕中期早期uE3和AFP水平无显著变化。我们还发现抑制素-A与疾病的发生和严重程度均相关。
唐氏综合征生化标志物水平在随后发生子痫前期的患者中发生改变，可能是子痫前期的一种有用筛查试验。抑制素-A是最具预测性的标志物，与随后子痫前期的严重程度相关，与子痫前期发生的孕周呈负相关。
