孕中期四联筛查试验与妊娠结局的相关性
Correlation of pregnancy outcome with quadruple screening test at second trimester.
作者信息
Yazdani Shahla, Rouholahnejad Rahele, Asnafi Nesa, Sharbatdaran Majid, Zakershob Marziihe, Bouzari Zinatossadat
机构信息
Associate Professor of Obstetrics and Gynecology Department, Fatemeh-Zahra Infertility and Reproductive Health Research Center, Babol University of Medical Sciences, Babol, Iran.
Resident of Obstetrics & Gynecology, Student Research Committee, Babol University of Medical Sciences, Babol, Iran.
出版信息
Med J Islam Repub Iran. 2015 Oct 19;29:281. eCollection 2015.
BACKGROUND
Abnormal levels of the markers AFP, hCG, and uE3 could be useful in predicting adverse pregnancy outcomes. This study was designed to determine the correlation between second trimester maternal serum markers and adverse pregnancy outcome (APO).
METHODS
In this historical cohort study, we randomly followed 231 obstetric patients with quadruple screening test in 14-18 weeks of gestation from March 2012 to March 2013 in a medical laboratory in Babol, Iran. We measured maternal serum levels of alphafetoprotein (AFP), human chorionic gonadotropin (hCG), unconjugated estriol (uE3), and inhibin-A. The risk of adverse pregnancy outcomes (APOs) were then compared between patients with negative and positive test results. We used Chi-square and Fisher-exact tests for qualitative variables and t-test for quantitative variables. Demographic differences between the two groups were minimized by applying logistic regression.
RESULTS
The risk of having an APO such as pre-eclampsia (p=0.008), fetal growth restriction (p=0.028) and premature rupture of membrane (p=0.040) increased significantly in patients with abnormal markers.
CONCLUSION
Abnormal results of quadruple screening test could be associated with APO in women with normal appearing fetus.
背景
甲胎蛋白（AFP）、人绒毛膜促性腺激素（hCG）和未结合雌三醇（uE3）水平异常可能有助于预测不良妊娠结局。本研究旨在确定孕中期母体血清标志物与不良妊娠结局（APO）之间的相关性。
方法
在这项历史性队列研究中，我们于2012年3月至2013年3月在伊朗巴博勒的一家医学实验室中，随机随访了231例在妊娠14 - 18周时进行四联筛查试验的产科患者。我们测量了母体血清中甲胎蛋白（AFP）、人绒毛膜促性腺激素（hCG）、未结合雌三醇（uE3）和抑制素A的水平。然后比较了检测结果为阴性和阳性的患者发生不良妊娠结局（APO）的风险。对于定性变量，我们使用卡方检验和费舍尔精确检验；对于定量变量，我们使用t检验。通过应用逻辑回归将两组之间的人口统计学差异降至最低。
结果
标志物异常的患者发生先兆子痫（p = 0.008）、胎儿生长受限（p = 0.028）和胎膜早破（p = 0.040）等不良妊娠结局的风险显著增加。
结论
四联筛查试验结果异常可能与外观正常胎儿的女性发生不良妊娠结局有关。
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