Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Rama IV Road, Pathumwan, Bangkok, 10330, Thailand.
Sci Rep. 2019 Aug 22;9(1):12266. doi: 10.1038/s41598-019-48727-8.
The aim of this study was to identify the value of serum SHARP1 levels and Doppler of the uterine artery in singleton pregnancy at 11-13 weeks for predicting preeclampsia. A prospective observational study was conducted in pregnant women at 11-13 weeks of pregnancy who had antenatal care at King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand, between January 2017 and January 2018. Serum SHARP1 measurement and transabdominal Doppler of the uterine artery were performed. The predictive values of these tests were determined. Data were obtained from 405 pregnant women. Thirty-five women had preeclampsia (8.6%), and six of these had early-onset preeclampsia (1.5%). Preeclamptic women had significantly lower serum SHARP1 levels than pregnant women without preeclampsia (3.6 ng/ml vs 4.7 ng/ml, p < 0.01). The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of serum SHARP1 levels of less than 3.89 ng/ml for predicting preeclampsia were 77.1%, 72.7%, 21.1% and 97.1%, respectively. For uterine artery Doppler, the sensitivity, specificity, PPV and NPV of the mean pulsatility index (PI) > 95 percentile for predicting preeclampsia were 5.7%, 95.4%, 10.5% and 91.5%, respectively. For the combination of serum SHARP1 levels with a cutoff value of less than 3.89 ng/ml and a mean PI > 95 percentile, the sensitivity, specificity, PPV and NPV were 77.1%, 70.3%, 19.7% and 97.0%, respectively. This study demonstrated that serum SHARP1 is a promising biomarker for predicting preeclampsia in the first trimester.
本研究旨在探讨 11-13 孕周时血清 SHARP1 水平联合子宫动脉多普勒检测在预测子痫前期中的应用价值。该前瞻性观察性研究于 2017 年 1 月至 2018 年 1 月在泰国曼谷朱拉隆功国王纪念医院进行，纳入在此期间进行产前检查的 11-13 孕周单胎妊娠孕妇。对所有孕妇进行血清 SHARP1 水平检测和子宫动脉多普勒超声检查，评估上述检测方法的预测价值。共纳入 405 例孕妇，其中 35 例（8.6%）孕妇被诊断为子痫前期，6 例（1.5%）为早发型子痫前期。与无子痫前期孕妇相比，子痫前期孕妇血清 SHARP1 水平显著降低（3.6ng/ml 比 4.7ng/ml，p<0.01）。血清 SHARP1 水平<3.89ng/ml 预测子痫前期的敏感度、特异度、阳性预测值（PPV）和阴性预测值（NPV）分别为 77.1%、72.7%、21.1%和 97.1%。对于子宫动脉多普勒，平均搏动指数（PI）>95 百分位数预测子痫前期的敏感度、特异度、PPV 和 NPV 分别为 5.7%、95.4%、10.5%和 91.5%。当血清 SHARP1 水平截断值<3.89ng/ml 联合子宫动脉多普勒 PI>95 百分位数时，其预测子痫前期的敏感度、特异度、PPV 和 NPV 分别为 77.1%、70.3%、19.7%和 97.0%。本研究表明，血清 SHARP1 是预测早发型子痫前期的一种有前景的生物标志物。
