母体人绒毛膜促性腺激素（hCG）浓度与儿童脑瘫（CP）风险。病例对照研究。
Maternal concentrations of human chorionic gonadotropin (hCG) and risk for cerebral palsy (CP) in the child. A case control study.
机构信息
Department of Obstetrics and Gynecology, Akershus University Hospital, 1478, Lørenskog, Norway; Institute of Clinical Medicine, University of Oslo, 0313, Oslo, Norway.
Norwegian Institutes for Urban and Regional Research (NIBR), Oslo and Akershus University College of Applied Sciences, 0130, Oslo, Norway.
出版信息
Eur J Obstet Gynecol Reprod Biol. 2018 Sep;228:203-208. doi: 10.1016/j.ejogrb.2018.07.003. Epub 2018 Jul 4.
BACKGROUND
Intrauterine conditions may be important in the development of cerebral palsy in the child. The hormone, human chorionic gonadotropin (hCG), is synthesized in the placenta, and hCG plays an important role in placental angiogenesis and development. Thus, maternal hCG concentrations may be an indicator of placental function and thereby the intrauterine environment for the offspring. We studied the associations of maternal concentrations of hCG during pregnancy with cerebral palsy in the child.
METHODS
We performed a case-control study nested within a cohort of 29,948 pregnancies in Norway during 1992-1994. Cases were all women within the cohort who gave birth to a singleton child with cerebral palsy diagnosed before five years of age (n = 63). Controls were a random sample of women with a singleton child without cerebral palsy (n = 182).
RESULTS
The adjusted odds ratio (OR) for cerebral palsyin the child was 0.78 (95% CI: 0.55-1.10) per log-transformed unit of maternal hCG in the 1 st trimester, and the OR was 1.42 (95% CI: 0.94-2.16) in the 2nd trimester. Thus, women who did not have high hCG concentrations in the 1 st trimester and low hCG concentrations in the 2nd trimester, had increased risk for giving birth to a child with cerebral palsy. Adjustments were made for pregnancy week of serum sampling, maternal age and parity.
CONCLUSIONS
The abnormal hCG concentrations in pregnancies with cerebral palsy in the offspring, could suggest placental factors as causes of cerebral palsy.
背景
宫内环境可能对儿童脑瘫的发展起着重要作用。激素人绒毛膜促性腺激素（hCG）在胎盘内合成，hCG 在胎盘血管生成和发育中起着重要作用。因此，母体 hCG 浓度可能是胎盘功能的指标，进而影响胎儿的宫内环境。我们研究了妊娠期间母体 hCG 浓度与儿童脑瘫之间的关联。
方法
我们在挪威于 1992-1994 年进行的一项队列研究中嵌套了一项病例对照研究，该队列包含 29948 例妊娠。病例均为该队列中分娩的脑瘫患儿的母亲（n=63），这些患儿在 5 岁前被诊断为脑瘫。对照组为该队列中分娩的无脑瘫患儿的母亲（n=182），采用随机抽样。
结果
第 1 孕期母体 hCG 的对数转换单位每增加 1 个单位，儿童脑瘫的调整后比值比（OR）为 0.78（95%CI：0.55-1.10），第 2 孕期的 OR 为 1.42（95%CI：0.94-2.16）。因此，第 1 孕期 hCG 浓度不高而第 2 孕期 hCG 浓度低的女性，生育脑瘫患儿的风险增加。调整了血清采样孕周、母亲年龄和产次。
结论
脑瘫患儿妊娠中异常的 hCG 浓度提示胎盘因素可能是脑瘫的原因。
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