E Holanda Moura Sammya Bezerra Maia, Park Felicity, Murthi Padma, Martins Wellington P, Kane Stefan C, Williams Paul, Hyett Jonathan, da Silva Costa Fabrício
a School of Medicine, University of Fortaleza (UNIFOR) , Ceará , Brazil .
b Department of Public Health , State University of Ceará , Fortaleza , Ceará , Brazil .
J Matern Fetal Neonatal Med. 2016 Mar;29(6):897-903. doi: 10.3109/14767058.2015.1022865. Epub 2015 Mar 17.
To examine whether the maternal serum concentration of the soluble receptor-1 of tumor necrosis factor-α (TNF-R1) at 11-13 + 6 weeks of gestation is a predictor of development of pre-eclampsia (PE).
This is a nested case-control study in which the concentration of TNF-R1 at 11 + 0 to 13 + 6 weeks was measured in 426 pregnant women in the first trimester. TNF-R1 values were expressed as multiples of the median (MoM) adjusted for maternal factors. The distributions of log TNF-R1 MoM in the control group and hypertensive disorders (early-PE [ePE], late-PE [lPE] and gestational hypertension [GH]) groups were compared. Logistic regression analysis was used to determine whether maternal factors, TNF-R1 or their combination make a significant contribution to the prediction of PE. Screening performance was determined by analysis of receiver-operating characteristics curves.
Median concentration of TNF-R1 (ng/ml) was higher in ePE (2.62 ± 0.67), lPE (2.12 ± 0.56) and GH (2.19 ± 0.45) compared to controls (2.04 ± 0.42), p = 0.001. Logistic regression analysis demonstrated that the addition of TNFR-1 to maternal factors did not make a significant contribution to the prediction of PE.
The maternal serum TNF-R1 concentration at 11-13 + 6 weeks of gestation was increased in pregnancies which developed hypertensive disorders, however, the addition of TNFR-1 did not improve the detection rate of these conditions compared with maternal factors alone.
探讨妊娠11 - 13⁺⁶周时孕妇血清中肿瘤坏死因子-α可溶性受体-1（TNF-R1）浓度是否为子痫前期（PE）发生的预测指标。
这是一项巢式病例对照研究，测定了426例孕早期孕妇在妊娠11⁺⁰至13⁺⁶周时的TNF-R1浓度。TNF-R1值以根据母体因素调整后的中位数倍数（MoM）表示。比较了对照组与高血压疾病组（早发型子痫前期[ePE]、晚发型子痫前期[lPE]和妊娠期高血压[GH]）中log TNF-R1 MoM的分布情况。采用逻辑回归分析确定母体因素、TNF-R1或它们的组合对PE预测是否有显著贡献。通过分析受试者工作特征曲线确定筛查性能。
与对照组（2.04±0.42）相比，ePE组（2.62±0.67）、lPE组（2.12±0.56）和GH组（2.19±0.45）的TNF-R1中位数浓度（ng/ml）更高，p = 0.001。逻辑回归分析表明，在母体因素基础上增加TNFR-1对PE的预测没有显著贡献。
发生高血压疾病的妊娠中，妊娠11 - 13⁺⁶周时孕妇血清TNF-R1浓度升高，然而，与仅考虑母体因素相比，增加TNFR-1并未提高这些疾病的检出率。
