Migda Michał, Migda Marian S, Migda Bartosz, Krzyżanowska Patrycja, Wender-Ożegowska Ewa
Clinical Unit of Obstetrics, Women's Disease and Gynecological Oncology, United District Hospital, Collegium Medicum University of Nicolaus Copernicus in Torun, Poland.
Ginekol Pol. 2016;87(9):644-650. doi: 10.5603/GP.2016.0060.
It is the prospective observational study aimed at early prediction of pregnancy complications in women with symptoms of MS.
124 Caucasian women in singleton pregnancies 11th to the 13th wks 6 days of gestation with MS criteria compared to 30 healthy controls. Perinatal maternal and fetal results were analyzed.
Increased in the MS group were: age (32.9 y vs. 28.6 y; p = 0,00), weight 11 to 13 + 6 weeks of gestation (79.0 kg vs. 59.7 kg; p = 0.00), BMI (29 kg/m² vs. 21.6 kg/m²; p = 0.00), waist-hip ratio (WHR) (0.9 vs. 0.8; p = 0.00). Maternal serum parameters were higher in the MS group: LDL-cholesterol (124.1 vs. 109.6 mg/dL; p = 0.02), t-PA (2556.8 vs. 1949.5 pg/mL; p < 0.00), GGTP (16.8 vs. 13.3 IU/L; p = 0.02) and lower values for: adiponectin (6.4 vs. 7.5 μg/mL; p = 0.01), SHBG (273.4 vs. 338.4 nmol/L; p = 0.001). MS group neonates higher body weight (3594.4 vs. 3312.2 g; p = 0.01), significantly frequent macrosomic neo-nates (> 4000 g) (20.9% vs. 6.6%; p = 0.042), GDM (12% vs. 0; p = 0.019).
Higher E-selectin serum concentration, GGTP and lower SHBG in first trimester are additionally to fasting maternal glucose, higher BMI and maternal age predictive for GDM. Higher E-selectin, fasting glucose, increased BMI and lower adiponectin serum concentration in first trimester are significant predictors of fetal macrosomia. Maternal BMI > 24.5 kg/m² is the best predictor of increased risk of fetal macrosomia and gestational diabetes mellitus.
本前瞻性观察性研究旨在早期预测患有多发性硬化症（MS）症状女性的妊娠并发症。
124例白人单胎妊娠女性，妊娠11至13周6天，符合MS标准，与30例健康对照者进行比较。分析围产期母婴结局。
MS组中升高的指标有：年龄（32.9岁对28.6岁；p = 0.00）、妊娠11至13 + 6周时的体重（79.0千克对59.7千克；p = 0.00）、体重指数（BMI）（29千克/平方米对21.6千克/平方米；p = 0.00）、腰臀比（WHR）（0.9对0.8；p = 0.00）。MS组的母体血清参数更高：低密度脂蛋白胆固醇（LDL - 胆固醇）（124.1对109.6毫克/分升；p = 0.02）、组织型纤溶酶原激活剂（t - PA）（2556.8对1949.5皮克/毫升；p < 0.00）、γ - 谷氨酰转肽酶（GGTP）（16.8对13.3国际单位/升；p = 0.02），而以下指标值更低：脂联素（6.4对7.5微克/毫升；p = 0.01）、性激素结合球蛋白（SHBG）（273.4对338.4纳摩尔/升；p = 0.001）。MS组新生儿体重更高（3594.4对3312.2克；p = 0.01），巨大儿（> 4000克）显著更常见（20.9%对6.6%；p = 0.042），妊娠期糖尿病（GDM）发生率更高（12%对0；p = 0.019）。
孕早期较高的E - 选择素血清浓度、GGTP以及较低的SHBG，除空腹母体血糖、较高的BMI和母体年龄外，也是妊娠期糖尿病的预测指标。孕早期较高的E - 选择素、空腹血糖、升高的BMI以及较低的脂联素血清浓度是巨大儿的显著预测指标。母体BMI > 24.5千克/平方米是胎儿巨大儿和妊娠期糖尿病风险增加的最佳预测指标。
