Tayyar Ahter Tanay, Tayyar Ahmet, Atakul Tolga, Yayla Cigdem Abide, Kilicci Cetin, Eser Ahmet, Karakus Resul, Herkiloglu Dilsat, Cundubey Cevat Rifat, Tayyar Mehmet
Department of Obstetrics and Gynecology, Health Sciences University, Zeynep Kamil Maternity and Children's Training and Research Hospital, Istanbul, Turkey.
Department of Obstetrics and Gynecology, Health Sciences University, Kanuni Sultan Süleyman Education and Research Hospital, Istanbul, Turkey.
Arch Med Sci. 2018 Jun;14(4):846-850. doi: 10.5114/aoms.2017.69865. Epub 2017 Sep 5.
The aim of this study is to compare first- and second-trimester Down syndrome biochemical screening markers in intrahepatic cholestasis of pregnancy (ICP) and normal pregnancies.
This observational case-control study was conducted at Health Sciences University Zeynep Kamil Maternity and Children's Health Training and Research Hospital and the Department of Obstetrics and Gynecology at Erciyes University Medical Faculty during 2016-2017. The study included 165 patients, and consisted of 62 women who had been diagnosed with ICP (the ICP-diagnosed group) and 103 healthy pregnant women (the control group). First-trimester free β-human chorionic gonadotropin (β-hCG), pregnancy-associated plasma protein-A (PAPP-A) and second-trimester total β-hCG, estriol (E3), α-fetoprotein (AFP), and inhibin A levels were compared between the two groups.
The mean patient age was 28.67 ±5.96 years, with no significant difference between the groups ( > 0.05). Average PAPP-A levels were significantly lower in the ICP-diagnosed group ( < 0.001). When the cut-off value for PAPP-A was taken as ≤ 0.93 multiple of median (MoM), the sensitivity and specificity values for ICP were 73.8% and 56.3%, respectively (95% CI, AUC ± SE: 0.663 ±0.042).
The decrease in PAPP-A MoM value indicates an increase in the risk of developing ICP, while changes in other markers were not sufficient to predict ICP.
本研究旨在比较妊娠肝内胆汁淤积症（ICP）孕妇与正常孕妇孕早期和孕中期唐氏综合征生化筛查标志物。
本观察性病例对照研究于2016 - 2017年在健康科学大学泽伊内普·卡米尔妇幼保健培训与研究医院以及埃尔西耶斯大学医学院妇产科进行。该研究纳入了165名患者，包括62名被诊断为ICP的女性（ICP诊断组）和103名健康孕妇（对照组）。比较了两组孕早期游离β-人绒毛膜促性腺激素（β-hCG）、妊娠相关血浆蛋白-A（PAPP-A）以及孕中期总β-hCG、雌三醇（E3）、甲胎蛋白（AFP）和抑制素A水平。
患者平均年龄为28.67±5.96岁，两组间无显著差异（>0.05）。ICP诊断组的平均PAPP-A水平显著较低（<0.001）。当PAPP-A的截断值取为≤0.93中位数倍数（MoM）时，ICP的敏感度和特异度值分别为73.8%和56.3%（95%CI，AUC±SE：0.663±0.042）。
PAPP-A MoM值降低表明发生ICP的风险增加，而其他标志物的变化不足以预测ICP。
