Hirashima Chikako, Ohkuchi Akihide, Takahashi Kayo, Suzuki Hirotada, Shirasuna Koumei, Matsubara Shigeki
Department of Obstetrics and Gynecology, Jichi Medical University, Shimotsuke-shi, Japan.
Laboratory of Animal Reproduction, Department of Agriculture, Tokyo University of Agriculture, Atsugi, Japan.
J Obstet Gynaecol Res. 2017 Aug;43(8):1285-1292. doi: 10.1111/jog.13360. Epub 2017 Jun 14.
Our aim was to investigate the effects of angiogenesis-related factor levels at 19-25 and 26-31 weeks of gestation (WG) on the later occurrence of a small-for-gestational-age (SGA) placenta (small placenta) or an SGA infant delivered at 35-41 WG.
We measured plasma levels of soluble fms-like tyrosine kinase 1 (sFlt-1) and placental growth factor (PlGF), and the serum level of soluble endoglin (sEng) in 679 pregnant women with blood sampling at both 19-25 and 26-31 WG in a prospective study. A small placenta and an SGA infant were defined as <10th percentile, respectively. Multivariate logistic regression analyses were performed using maternal factors, a high mean pulsatility index (high mPI) of the uterine artery in the second trimester, and angiogenesis-related factor levels.
Regarding the occurrence of a small placenta, low PlGF at 19-25 WG (adjusted odds ratio [95% confidence interval]: 2.4 [1.01-5.7]) and a high mPI (2.5 [1.4-4.3]) were independent risk factors. Moreover, low PlGF at 26-31 WG (3.3 [1.5-7.0]) was also an independent risk factor after adjusting for the effect of mPI. Concerning the occurrence of an SGA infant, a high mPI (2.8 [1.6-5.2]) and high sEng at 26-31 WG (2.3 [1.2-4.5]) were independent risk factors.
Low levels of PlGF at 19-25 and 26-31 WG were independent risk factors for a small placenta at ≥35 WG; and a high sEng at 26-31 WG was an independent risk factor for an SGA infant at ≥35 WG.
我们的目的是研究妊娠19 - 25周和26 - 31周时血管生成相关因子水平对后期发生小于胎龄儿（SGA）胎盘（小胎盘）或在妊娠35 - 41周时出生的SGA婴儿的影响。
在一项前瞻性研究中，我们对67名在妊娠19 - 25周和26 - 31周时均进行采血的孕妇，测量其血浆中可溶性fms样酪氨酸激酶1（sFlt - 1）和胎盘生长因子（PlGF）的水平，以及血清中可溶性内皮糖蛋白（sEng）的水平。小胎盘和SGA婴儿分别定义为低于第10百分位数。使用母亲因素、孕中期子宫动脉高平均搏动指数（高mPI）和血管生成相关因子水平进行多变量逻辑回归分析。
关于小胎盘的发生，妊娠19 - 25周时低PlGF（调整后的优势比[95%置信区间]：2.4[1.01 -
5.7]）和高mPI（2.5[1.4 - 4.3]）是独立危险因素。此外，在调整mPI的影响后，妊娠26 - 31周时低PlGF（3.3[1.5 - 7.0]）也是一个独立危险因素。关于SGA婴儿的发生，高mPI（2.8[1.6 - 5.2]）和妊娠26 - 31周时高sEng（2.3[1.2 - 4.5]）是独立危险因素。
妊娠19 - 25周和2憨 - 31周时低水平的PlGF是妊娠≥35周时小胎盘的独立危险因素；妊娠26 - 31周时高sEng是妊娠≥35周时SGA婴儿的独立危险因素。
