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妊娠相关血浆蛋白A(PAPP-A)是否为早产孤立性羊水过少病例围产期不良结局的标志物?

Is pregnancy associated plasma protein-A (PAPP-A) a marker for adverse perinatal outcomes in preterm isolated oligohydramnios cases?

作者信息

Ozgen Gulten, Dincgez Cakmak Burcu, Dundar Betul, Tasgoz Fatma Nurgul, Bayram Feyza, Karadag Burak

机构信息

Bursa Yuksek Ihtisas Research and Training Hospital, Department of Obstetrics and Gynecology, Bursa, Turkey.

Bursa Yuksek Ihtisas Research and Training Hospital, Department of Obstetrics and Gynecology, Bursa, Turkey.

出版信息

Taiwan J Obstet Gynecol. 2018 Feb;57(1):71-75. doi: 10.1016/j.tjog.2017.12.012.

Abstract

OBJECTIVE

Isolated oligohydramnios is defined as an amniotic fluid index below five centimeter with no other coexisting condition. There are still controversies about the management and pregnancy outcomes. A marker predicting these is crucial. Low pregnancy associated plasma protein-A levels were reported to be related with adverse pregnancy outcomes. We aimed to determine the role of first trimester pregnancy associated plasma protein-A for poor outcomes in preterm isolated oligohydramnios cases.

MATERIAL AND METHODS

Fifty-one patients with singleton pregnancies diagnosed as isolated oligohydramnios at 28/0-36/6 weeks of gestation and 110 gestational age matched healthy controls between January and December 2015 were included. Maternal age, gestational age at delivery, mode of delivery, indication for cesarean section, Apgar scores at first and fifth minutes, birth weight, neonatal intensive care unit admission and mortality were recorded. Pregnancy associated plasma protein-A levels were compared between groups and its role in adverse perinatal outcomes was evaluated.

RESULTS

Pregnancy associated plasma protein-A levels and pregnancy outcomes were similar in two groups (p > 0.050) except birth weight, gestational age at delivery and presence of fetal distress. Pregnancy associated plasma protein-A levels did not differ in terms of delivery mode, presence of fetal distress, first and fifth minutes Apgar scores and neonatal intensive care unit admission (p = 0.323,0.650,0.990,0.112,0.853). Also, it was not determined as a risk factor for cesarean section, presence of fetal distress, low Apgar scores and neonatal intensive care unit admission.

CONCLUSION

Pregnancy associated plasma protein-A, a well-known prognostic factor for some of high risk pregnancy conditions, may not be used as a marker in preterm isolated oligohydramnios cases.

摘要

目的

孤立性羊水过少定义为羊水指数低于5厘米且无其他并存情况。关于其管理和妊娠结局仍存在争议。预测这些情况的标志物至关重要。据报道,妊娠相关血浆蛋白A水平低与不良妊娠结局有关。我们旨在确定孕早期妊娠相关血浆蛋白A在早产孤立性羊水过少病例不良结局中的作用。

材料与方法

纳入2015年1月至12月期间51例在妊娠28/0 - 36/6周时被诊断为孤立性羊水过少的单胎妊娠患者以及110例孕周匹配的健康对照者。记录产妇年龄、分娩时孕周、分娩方式、剖宫产指征、第1分钟和第5分钟的阿氏评分、出生体重、新生儿重症监护病房入住情况和死亡率。比较两组之间的妊娠相关血浆蛋白A水平,并评估其在围产期不良结局中的作用。

结果

除出生体重、分娩时孕周和胎儿窘迫情况外,两组的妊娠相关血浆蛋白A水平和妊娠结局相似(p > 0.050)。妊娠相关血浆蛋白A水平在分娩方式、胎儿窘迫情况、第1分钟和第5分钟阿氏评分以及新生儿重症监护病房入住方面无差异(p = 0.323、0.650、0.990、0.112、0.853)。此外,它未被确定为剖宫产、胎儿窘迫、低阿氏评分和新生儿重症监护病房入住的危险因素。

结论

妊娠相关血浆蛋白A是一些高危妊娠情况的著名预后因素,但在早产孤立性羊水过少病例中可能不能用作标志物。

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