Larroca Santiago Garcia-Tizon, Arevalo-Serrano Juan, Abad Virginia Ortega, Recarte Pilar Pintado, Carreras Alejandro Garcia, Pastor Gonzalo Nozaleda, Hernandez Cesar Rodriguez, Pacheco Ricardo Perez Fernandez, Luis Juan De Leon
Department of Obstetrics and Gynecology, Hospital General, Universitario Gregorio Marañon de Madrid, Madrid, Spain.
Department of Internal Medicine, Hospital Universitario, Principe de Asturias de Alcalá de Henares, Madrid, Spain.
Open Access Maced J Med Sci. 2017 Mar 15;5(1):27-32. doi: 10.3889/oamjms.2017.013. Epub 2017 Feb 1.
To rule out maternal and pregnancy factors that may contribute to platelet count (PLT) changes in the first trimester of gestation and examine if there is any association between its levels and adverse perinatal outcome.
The study population included all patients from the first-trimester visit between 2013-2015 with pregnancy results. Linear multiple regression was constructed to rule out variables that may have a significant contribution to PLT. For each adverse outcome at birth, multiple logistic regression analysis was implemented to estimate the PLT effect.
PLT was measured in 6092 patients. There was the significant contribution on PLT in the first trimester from maternal weight, the presence of rheumatologic disease, BHCG levels and MPV. There was a significant association between PLT and abnormal cardiotocography at delivery (OR 1.004; IC95% 1.001 to 1.007) and C-Section due to abnormal CTG (OR 1.005; IC95% 1.002 to 1.008). When adjusted for factors that interact with PLT there was also a significant association with pH at birth < 7.10 and gestational diabetes.
Maternal and pregnancy factors can poorly predict relevant changes in PLT at the first trimester of gestation. PLT at first trimester of pregnancy might predict adverse perinatal outcome in combination with other markers.
排除可能导致妊娠早期血小板计数(PLT)变化的母体和妊娠因素,并检查其水平与围产期不良结局之间是否存在关联。
研究人群包括2013 - 2015年间首次妊娠检查且有妊娠结果的所有患者。构建线性多元回归以排除可能对PLT有显著影响的变量。对于每一项出生时的不良结局,进行多元逻辑回归分析以评估PLT的影响。
对6092例患者进行了PLT测量。妊娠早期母体体重、风湿性疾病的存在、BHCG水平和MPV对PLT有显著影响。PLT与分娩时异常胎心监护(OR 1.004;95%置信区间1.001至1.007)以及因异常CTG行剖宫产(OR 1.005;95%置信区间1.002至1.008)之间存在显著关联。在对与PLT相互作用的因素进行校正后,PLT与出生时pH < 7.10和妊娠期糖尿病之间也存在显著关联。
母体和妊娠因素对妊娠早期PLT的相关变化预测能力较差。妊娠早期的PLT可能与其他标志物一起预测围产期不良结局。