母体血清妊娠相关血浆蛋白A作为产科并发症的早期标志物？

Maternal serum PAPP-A as an early marker of obstetric complications?

作者信息

Quattrocchi Tommasa, Baviera Giovanni, Pochiero Teresa, Basile Francesca, Rizzo Laura, Santamaria Angelo, Corrado Francesco, D'Anna Rosario

机构信息

Department of Pediatrics, Gynecology, Microbiology and Biomedical Sciences, University of Messina, Messina, Italy.

出版信息

Fetal Diagn Ther. 2015;37(1):33-6. doi: 10.1159/000365147. Epub 2014 Aug 15.

DOI:10.1159/000365147

PMID:25139218

Abstract

OBJECTIVE

The aim of this study was to investigate whether low first-trimester PAPP-A levels are associated with an adverse pregnancy outcome.

MATERIALS AND METHODS

A retrospective case-control study was carried out using a Down's syndrome assays database over a 6-year period, between the 8th and 11th week of pregnancy. There were 164 women with PAPP-A multiples of median (MoM) levels <0.3 and 1,640 women with PAPP-A MoM levels ≥0.3 who served as a control group. Outcome measures were the prevalence of miscarriages, gestational hypertension, preeclampsia, pre-term delivery, gestational diabetes and intrauterine growth retardation in both groups.

RESULTS

The two groups significantly differed only for miscarriages: 29 (17.7%) vs. 159 (9.7%), p = 0.04, OR 1.7; gestational hypertension: 15 (9.1%) vs. 74 (4.5%), p = 0.02, OR 2.1, and preeclampsia: 9 (5.5%) vs. 29 (1.8%), p = 0.02, OR 2.5.

DISCUSSION

Even if in this study the PAPP-A cutoff considered was lower and was assayed in an earlier period compared with other studies, the detection rate for adverse pregnancy outcomes did not improve.

摘要

目的

本研究旨在调查孕早期妊娠相关血浆蛋白A（PAPP-A）水平低是否与不良妊娠结局相关。

材料与方法

利用一个唐氏综合征检测数据库进行一项回顾性病例对照研究，研究为期6年，时间范围为妊娠第8至11周。有164名妇女的PAPP-A水平为中位数倍数（MoM）<0.3，另有1640名妇女的PAPP-A MoM水平≥0.3作为对照组。观察指标为两组中流产、妊娠期高血压、子痫前期、早产、妊娠期糖尿病和胎儿宫内生长受限的发生率。

结果

两组之间仅在流产方面存在显著差异：分别为29例（17.7%）对159例（9.7%），p = 0.04，比值比（OR）为1.7；妊娠期高血压方面：分别为15例（9.1%）对74例（4.5%）, p = 0.02，OR为2.1；子痫前期方面：分别为9例（5.5%）对29例（1.8%），p = 0.02，OR为2.5。