Laughon S Katherine, Rebarber Andrei, Rolnitzky Linda, Fink Lois, Saltzman Daniel H
University of Pittsburgh, Magee-Women's Hospital, Pennsylvania 15213, USA.
Am J Perinatol. 2009 Aug;26(7):491-4. doi: 10.1055/s-0029-1214250. Epub 2009 Mar 13.
We investigated whether abnormal concentrations of first-trimester free-beta subunit human chorionic gonadotropin (fsshCG) and pregnancy-associated plasma protein A (PAPP-A) are associated with preterm delivery in twin gestations. This was a hospital-based, retrospective study of 70 twin gestations between 11 (1)/ (7) and 13 (6)/ (7) weeks' gestation undergoing first-trimester screening. Free betahCG and PAPP-A multiples of the median were determined by our laboratory standards. Odds ratios (ORs) were estimated that compared the prevalence of very preterm (< 32 weeks), preterm (> or = 32 and < 37 weeks), and term birth (> or = 37 weeks) between the lower and higher percentile groups for each analyte. FsshCG levels < or = 25th percentile were associated with very preterm birth < 32 weeks' gestation (OR 5.10; 95% confidence interval [CI]: 1.19 to 21.95), but not with preterm birth > or = 32 and < 37 weeks' gestation (OR 0.50; 95% CI: 0.16 to 1.61). PAPP-A was not associated with very preterm (OR 2.95; 95% CI: 0.69 to 12.60) or preterm birth (OR 0.71; 95% CI: 0.23 to 2.21). Low first-trimester fsshCG was a strong predictor for very preterm birth in twin gestations. Low first-trimester PAPP-A was associated with a trend in increased risk of very preterm birth.
我们调查了孕早期游离β亚基人绒毛膜促性腺激素（fsshCG）和妊娠相关血浆蛋白A（PAPP-A）的异常浓度是否与双胎妊娠早产有关。这是一项基于医院的回顾性研究，研究对象为70例孕11（1）/（7）至13（6）/（7）周接受孕早期筛查的双胎妊娠。游离β-hCG和PAPP-A的中位数倍数根据我们的实验室标准确定。估计比值比（OR）以比较每种分析物低百分位数组和高百分位数组之间极早产（<32周）、早产（≥32周且<37周）和足月产（≥37周）的发生率。fsshCG水平≤第25百分位数与妊娠<3~2周的极早产相关（OR 5.10；95%置信区间[CI]：1.19至21.95），但与妊娠≥32周且<37周的早产无关（OR 0.50；95%CI：0.16至1.61）。PAPP-A与极早产（OR 2.95；95%CI：0.69至12.60）或早产（OR 0.71；95%CI：0.23至2.21）无关。孕早期fsshCG水平低是双胎妊娠极早产的有力预测指标。孕早期PAPP-A水平低与极早产风险增加的趋势相关。
