Chełchowska Magdalena, Gajewska Joanna, Mazur Joanna, Ambroszkiewicz Jadwiga, Maciejewski Tomasz M, Leibschang Jerzy
Screening Department, Institute of Mother and Child, Warsaw, Poland.
Department of Child and Adolescent Health, Institute of Mother and Child, Warsaw, Poland.
Arch Med Sci. 2016 Dec 1;12(6):1256-1262. doi: 10.5114/aoms.2016.62908. Epub 2016 Oct 24.
The purpose of this study was to evaluate the associations of the first, second and third trimester serum pregnancy-associated plasma protein A (PAPP-A) concentrations with neonatal anthropometric parameters. The effect of tobacco smoking during pregnancy on PAPP-A level was also studied.
One hundred and fifty healthy pregnant women were divided into smoking and tobacco-abstinent groups. Serum PAPP-A level was measured with the KRYPTOR rapid random-access immunoassay analyzer. The relationship between PAPP-A and newborn related outcome as well as markers of estimated intensity of cigarette smoking was evaluated by univariate and multivariate linear regression.
Pregnancy-associated plasma protein A concentration was positively correlated with birth weight in the first (β = 31.6; < 0.001), second (β = 10.6; < 0.05), and third (β = 4.6; < 0.001) trimester of gestation. A significant association between PAPP-A and birth body length and head circumference in the second (β = 0.02; < 0.05) and third trimester (β = 0.01; < 0.01) was also found. The serum PAPP-A levels were significantly lower in the smoking than in the tobacco-abstinent group in each trimester of pregnancy ( < 0.001). The largest impact of the number of cigarettes smoked per day on PAPP-A level was found in the second (β = -1.2; = 0.004) and third trimester (β = -2.6; = 0.001).
Maternal serum PAPP-A levels during gestation might be significant predictors for birth weight. Increased PAPP-A concentrations in the second and third trimester appeared to also be predictive for newborn body length and head circumference. Smoking alters maternal PAPP-A levels in all trimesters, with the greatest impact related to the number of cigarettes smoked per day.
本研究旨在评估孕早期、孕中期和孕晚期血清妊娠相关血浆蛋白A（PAPP-A）浓度与新生儿人体测量参数之间的关联。同时也研究了孕期吸烟对PAPP-A水平的影响。
150名健康孕妇被分为吸烟组和非吸烟组。采用KRYPTOR快速随机免疫分析仪检测血清PAPP-A水平。通过单因素和多因素线性回归评估PAPP-A与新生儿相关结局以及吸烟估计强度标志物之间的关系。
妊娠相关血浆蛋白A浓度在妊娠第一期（β = 31.6；<0.001）、第二期（β = 10.6；<0.05）和第三期（β = 4.6；<0.001）与出生体重呈正相关。在妊娠第二期（β = 0.02；<0.05）和第三期（β = 0.01；<0.01）也发现PAPP-A与出生身长和头围之间存在显著关联。在妊娠各期，吸烟组的血清PAPP-A水平均显著低于非吸烟组（<0.001）。发现每日吸烟量对PAPP-A水平的最大影响出现在妊娠第二期（β = -1.2；= 0.004）和第三期（β = -2.6；= 0.001）。
孕期母体血清PAPP-A水平可能是出生体重的重要预测指标。孕中期和孕晚期PAPP-A浓度升高似乎也可预测新生儿身长和头围。吸烟会改变孕期各阶段母体的PAPP-A水平，其中与每日吸烟量的关系最为密切。
