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母血中游离DNA的胎儿分数在预测自发性早产中的应用

Fetal fraction of cell-free DNA in maternal plasma in the prediction of spontaneous preterm delivery.

作者信息

Quezada M S, Francisco C, Dumitrascu-Biris D, Nicolaides K H, Poon L C

机构信息

Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK.

出版信息

Ultrasound Obstet Gynecol. 2015 Jan;45(1):101-5. doi: 10.1002/uog.14666. Epub 2014 Nov 28.

Abstract

OBJECTIVES

To investigate whether, in pregnancies complicated by spontaneous preterm delivery, fetal fraction of cell-free DNA (cfDNA) in maternal plasma at 11-13 weeks' gestation is altered and if this measurement could be useful in the prediction of preterm delivery.

METHODS

Fetal fraction of cfDNA was measured at 10 + 0 to 13 + 6 weeks' gestation in 3169 pregnancies, 3066 (96.7%) that delivered at ≥ 37 weeks and 103 (3.3%) with spontaneous delivery at < 37 weeks, including 21 that delivered at < 34 weeks and 82 that delivered at 34-37 weeks. The measured fetal fraction was converted to multiples of the median (MoM), corrected for maternal characteristics and gestational age, and the Mann-Whitney U-test was used to determine the significance of differences in the median values in the spontaneous preterm delivery groups from that in the term delivery group.

RESULTS

In the spontaneous preterm delivery groups (< 34 weeks' gestation, 34-37 weeks, < 37 weeks), compared to the term delivery group, there was no significant difference in the median fetal fraction MoM (1.004, 0.922 and 0.946, respectively, vs 1.015).

CONCLUSION

Measurement of fetal fraction in maternal plasma at 11-13 weeks' gestation is not predictive of spontaneous preterm delivery.

摘要

目的

探讨在妊娠合并自发性早产的情况下,孕11 - 13周时母血中游离DNA(cfDNA)的胎儿分数是否发生改变,以及该测量值是否有助于预测早产。

方法

在3169例妊娠中,于孕10⁺⁰至13⁺⁶周测量cfDNA的胎儿分数,其中3066例(96.7%)在≥37周分娩,103例(3.3%)为<37周的自发性分娩,包括21例在<34周分娩和82例在34 - 37周分娩。将测得的胎儿分数转换为中位数倍数(MoM),并根据母亲特征和孕周进行校正,采用Mann-Whitney U检验来确定自发性早产组与足月分娩组中位数差异的显著性。

结果

在自发性早产组(<34周妊娠、34 - 37周、<37周)中,与足月分娩组相比,胎儿分数MoM的中位数无显著差异(分别为1.004、0.922和0.946,对比1.015)。

结论

孕11 - 13周时测量母血中的胎儿分数不能预测自发性早产。

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