Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK.
Prenat Diagn. 2011 May;31(5):479-83. doi: 10.1002/pd.2723. Epub 2011 Mar 10.
To examine the potential role of maternal serum level of adiponectin in the first trimester of pregnancy in the prediction of neonatal macrosomia.
Maternal serum adiponectin concentration was measured in a case-control study of singleton pregnancies at 11 to 13 weeks' gestation, which included 50 cases that subsequently delivered macrosomic neonates with birth weight above the 95th percentile for gestation at delivery and 300 controls who delivered appropriate for gestational age neonates. The median multiple of the median (MoM) serum adiponectin in the two outcome groups was compared and the bivariate Gaussian distributions were simulated in a screened population of 33 344 pregnancies to estimate the performance of screening for macrosomia by a combination of maternal characteristics and obstetric history with serum adiponectin.
In the macrosomic group the median serum adiponectin [0.82, interquartile range (IQR): 0.56-1.02 MoM] was significantly lower than in the non-macrosomic controls (1.02, IQR: 0.70-1.29 MoM; p = 0.001). The estimated detection rate of macrosomia, at fixed false positive rate of 10%, from maternal characteristics and obstetric history was 34.6% and this increased to 38.2% with the addition of serum adiponectin.
Maternal serum adiponectin at 11 to 13 weeks is a useful biomarker for early prediction of macrosomia.
探讨妊娠 11～13 周孕妇血清脂联素水平在预测巨大儿中的作用。
采用病例对照研究，选取孕 11～13 周的单胎妊娠孕妇，50 例为巨大儿组（出生体重高于相应胎龄第 95 百分位），300 例为对照组（适于胎龄儿），检测孕妇血清脂联素浓度。比较两组血清脂联素中位数倍数（MoM），并对 33 344 例筛查人群进行双变量正态分布模拟，以估计母性特征、产科病史联合血清脂联素对巨大儿的筛查效能。
巨大儿组血清脂联素中位数[0.82，四分位间距（IQR）：0.56～1.02 MoM]显著低于对照组（1.02，IQR：0.70～1.29 MoM；p=0.001）。在固定假阳性率为 10%时，母性特征和产科病史对巨大儿的检出率为 34.6%，联合血清脂联素后检出率增加至 38.2%。
妊娠 11～13 周时孕妇血清脂联素水平是预测巨大儿的有用生物标志物。
