Tongprasert Fuanglada, Srisupundit Kasemsri, Luewan Suchaya, Tongsong Theera
Maternal Fetal Medicine Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University , Chiang Mai , Thailand.
J Matern Fetal Neonatal Med. 2014 Jul;27(10):1005-9. doi: 10.3109/14767058.2013.852532. Epub 2013 Nov 7.
To compare the levels of inhibin-A between pregnancies with fetal anemia secondary to Hb Bart's disease and pregnancies with normal non-anemic fetuses.
Sixty-five pregnancies at risk of fetal Hb Bart's disease scheduled for cordocentesis at 18-22 weeks were prospectively recruited into the study. Inhibin-A levels were measured from maternal blood drawn before cordocentesis. Fetal blood samples were collected for fetal Hb typing and hemoglobin (Hb) levels.
Maternal serum inhibin-A was significantly higher in women with fetal Hb Bart's disease than those with unaffected fetuses (1.03 MoM (multiple of median) and 0.75 MoM, respectively, p = 0.001). The relationship between maternal serum inhibin-A and fetal Hb level was a quadratic equation; inhibin-A = 5.248 - 9.415(Hb) + 4.919(Hb)(2) (r(2) = 0.274, p < 0.001). Maternal serum inhibin-A did not correlate with cardiomegaly but was significantly associated with placental thickness; inhibin-A = 1.372 - 0.751(Pl) + 0.214(Pl)(2) (r(2) = 0.237, p = 0.007).
Maternal serum inhibin-A levels were significantly higher in pregnancies with fetal Hb Bart's disease. The elevation of inhibin-A was likely to be a consequence of fetal anemia and placentomegaly. Since inhibin-A is commonly used as a component of quadruple test; the calculated risk of Down's syndrome may be unreliable in pregnancies with fetal Hb Bart's disease or possible fetal anemia.
比较继发于血红蛋白巴特氏病的胎儿贫血妊娠与正常非贫血胎儿妊娠的抑制素A水平。
前瞻性招募65例计划在18 - 22周进行脐带穿刺的有胎儿血红蛋白巴特氏病风险的妊娠病例进入研究。在脐带穿刺前采集母血测量抑制素A水平。采集胎儿血样进行胎儿血红蛋白分型和血红蛋白（Hb）水平检测。
胎儿患有血红蛋白巴特氏病的女性母血清抑制素A显著高于胎儿未受影响的女性（分别为1.03中位数倍数（MoM）和0.75 MoM，p = 0.001）。母血清抑制素A与胎儿Hb水平的关系为二次方程；抑制素A = 5.248 - 9.415（Hb）+ 4.919（Hb）²（r² = 0.274，p < 0.001）。母血清抑制素A与心脏肥大无关，但与胎盘厚度显著相关；抑制素A = 1.372 - 0.751（Pl）+ 0.214（Pl）²（r² = 0.237，p = 0.007）。
胎儿患有血红蛋白巴特氏病的妊娠中母血清抑制素A水平显著更高。抑制素A升高可能是胎儿贫血和胎盘肿大的结果。由于抑制素A通常用作四联筛查的一个组成部分；在患有胎儿血红蛋白巴特氏病或可能存在胎儿贫血的妊娠中，计算出的唐氏综合征风险可能不可靠。
