Qi Hong, Bian Xu-Ming, Jiang Yu-Lin, Liu Shan-Ying, Guo Qi
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Zhonghua Fu Chan Ke Za Zhi. 2009 Jun;44(6):401-4.
To explore the relationship between pregnant outcomes and the maternal serum level of a disintegrin and metalloprotease 12 (ADAM 12) in the first trimester.
From July 2007 to January 2008, the serum levels of ADAM 12 of 511 women in their first trimester (6 - 13 gestational weeks), who attended the clinics at Peking Union Medical College Hospital, were tested by Time-Resolved Fluorescence Immunoassay (TR-FIA), and the results and pregnant outcomes were analyzed.
(1) The median levels of ADAM 12 at 6, 7, 8, 9, 10, 11, 12, 13 weeks of gestation were 14.63 microg/L, 35.08 microg/L, 88.90 microg/L, 186.51 microg/L, 370.62 microg/L, 537.71 microg/L, 632.55 microg/L, and 769.42 microg/L, respectively, showing a linear increase with the gestational age (r =0. 992, P < 0.01). (2) Among the 511 pregnancies, 427 were normal singleton term pregnancies and 84 had adverse perinatal outcomes. Twenty-seven miscarriages (5.3%, 27/511) and 5 ectopic pregnancies were reported and the Multiple of Medians (MOM) of them were 0.24 and 0.32, respectively, which was significantly lower than the normal singleton pregnancies (1.01, P < 0.05). However, the serum level of ADAM 12 in 5 women with placenta previa (MOM = 1.45) was significantly higher than the normal ones (P < 0.05). No significant correlation was found between the fetal birth weight and maternal serum level of ADAM 12 in the first trimester (r = -0.15, P < 0.05). (3) Thirteen cases with chromosomal abnormalities was identified out of 97 cases who received fetal karyotyping, including 3 Down's syndrome and 2 Turner syndrome, and the MOM of ADAM 12 in these 13 cases (0.34) was significantly different from those normal singleton pregnancies (P < 0.05). MoMs of ADAM 12 in 10 euchromosome aneupolyhaploids cases (0.29)were lower than the normal ones (P < 0.05).
The maternal serum level of ADAM 12 in the first-trimester is a potential marker for aneupolyhaploid screening and early fetal loss prediction, and is suggested to be tested at 9-12 gestational weeks as part of prenatal screening.
探讨孕早期孕妇血清中解整合素金属蛋白酶12（ADAM 12）水平与妊娠结局之间的关系。
2007年7月至2008年1月，对在北京协和医院门诊就诊的511例孕早期（妊娠6 - 13周）妇女，采用时间分辨荧光免疫分析法（TR-FIA）检测血清ADAM 12水平，并分析检测结果与妊娠结局。
（1）妊娠6、7、8、9、10、11、12、13周时ADAM 12的中位数水平分别为14.63μg/L、35.08μg/L、88.90μg/L、186.51μg/L、370.62μg/L、537.71μg/L、632.55μg/L和769.42μg/L，随孕周呈线性升高（r =0.992，P < 0.01）。（2）511例妊娠中，427例为正常单胎足月妊娠，84例有不良围产结局。报告27例流产（5.3%，27/511）和5例异位妊娠，其倍数中位数（MOM）分别为0.24和0.32，显著低于正常单胎妊娠（1.01，P < 0.05）。然而，5例前置胎盘孕妇的血清ADAM 12水平（MOM = 1.45）显著高于正常孕妇（P < 0.05）。孕早期胎儿出生体重与孕妇血清ADAM 12水平之间无显著相关性（r = -0.15，P < 0.05）。（3）97例行胎儿核型分析的病例中，确诊13例染色体异常，包括3例唐氏综合征和2例特纳综合征，这13例病例中ADAM 12的MOM（0.34）与正常单胎妊娠者显著不同（P < 0.05）。10例常染色体非整倍单倍体病例中ADAM 12的MOM（0.29）低于正常者（P < 0.05）。
孕早期孕妇血清ADAM 12水平是进行非整倍单倍体筛查及预测早期胎儿丢失的潜在标志物，建议在妊娠9 - 12周进行检测作为产前筛查的一部分。
