妊娠 8-13 周孕妇血清胎盘生长因子在非整倍体筛查中的前瞻性研究。

Maternal serum placental growth factor in prospective screening for aneuploidies at 8-13 weeks' gestation.

机构信息

Department of Fetal Medicine, University College Hospital, London, UK.

出版信息

Fetal Diagn Ther. 2012;31(2):87-93. doi: 10.1159/000335684. Epub 2012 Jan 27.

DOI:10.1159/000335684

PMID:22286035

Abstract

OBJECTIVE

To investigate whether measurement of maternal serum placental growth factor (PLGF) can improve the performance of first-trimester combined screening for trisomy-21 by fetal nuchal translucency (NT) thickness and serum free β-human chorionic gonadotropin (β-hCG) and PAPP-A.

METHODS

In singleton pregnancies attending for routine care, serum PLGF, free β-hCG and PAPP-A were measured at 8(+0)-13(+6) weeks' gestation, and fetal NT was measured at 11(+0)-13(+6) weeks. The population included 12,154 normal and 44 trisomy-21 pregnancies. We examined the effect of adding PLGF on the performance of screening by the combined test.

RESULTS

In the trisomy-21 pregnancies the median multiple of the normal median PLGF, adjusted for gestational age, maternal weight, racial origin, smoking status and method of conception, was significantly reduced (0.6070, 95% CI 0.5543-0.6648), and this did not change significantly with gestational age. Adding PLGF to combined testing with a risk cut-off of 1 in 100 reduced the false positive rate from 2.7% (95% CI 2.5-3.0) to 2.6% (95% CI 2.4-2.8) and increased the detection rate from 85% (95% CI 75-93) to 88% (95% CI 78-95).

CONCLUSIONS

Inclusion of serum PLGF improves the performance of the first-trimester combined test in screening for trisomy-21.

摘要

目的

探讨测量母体血清胎盘生长因子（PLGF）是否可以改善妊娠 11 至 13 周+6 时胎儿颈项透明层（NT）厚度和血清游离β-人绒毛膜促性腺激素（β-hCG）和妊娠相关血浆蛋白 A（PAPP-A）联合筛查 21 三体的性能。

方法

在常规护理的单胎妊娠中，于妊娠 8（+0）至 13（+6）周时测量血清 PLGF、游离β-hCG 和 PAPP-A，并于妊娠 11（+0）至 13（+6）周时测量胎儿 NT。该人群包括 12154 例正常妊娠和 44 例 21 三体妊娠。我们检查了添加 PLGF 对联合检测筛查性能的影响。

结果

在 21 三体妊娠中，经胎龄、母亲体重、种族、吸烟状况和受孕方式校正后的中位数倍数 PLGF 明显降低（0.6070，95%CI 0.5543-0.6648），且这与胎龄无明显变化。将 PLGF 添加到风险截断值为 1/100 的联合检测中，将假阳性率从 2.7%（95%CI 2.5-3.0）降低至 2.6%（95%CI 2.4-2.8），检测率从 85%（95%CI 75-93）增加至 88%（95%CI 78-95）。