Department of Obstetrics and Gynecology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea.
Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea.
J Matern Fetal Neonatal Med. 2021 Nov;34(21):3623-3628. doi: 10.1080/14767058.2019.1686757. Epub 2019 Nov 18.
To develop preeclampsia (PE) risk prediction model based on maternal characteristics and serum markers at the first and second trimester in the twin pregnancy.
Between January 2005 and September 2017, we retrospectively reviewed medical records of 532 twin pregnant women who underwent maternal serum integrated test and gave birth at a Bundang CHA Medical Center. Maternal serum pregnancy-associated plasma protein A (PAPP-A) was determined at 10 to 13 weeks and the serum alpha-fetoprotein (MSAFP), human chorionic gonadotrophin (hCG), unconjugated estriol (uE) and inhibin A were assayed at 14 to 22weeks. We assessed the relationships of maternal characteristics and serum markers by using multiple logistic regression analysis.
The study included 35 patients who diagnosed PE and a control group consisting of the other 497 patients in twin pregnancy. There were no significant differences in the maternal age and body mass index (BMI) between two groups. However, the gestational age and placenta weight at delivery were significantly different between groups ( < .001, = .005, respectively. Among the maternal serum markers, inhibin A value was significantly higher in women with PE compared to those without preeclampsia ( < .001). In addition, we predicted the PE using maternal age, BMI, uE, and inhibin A which were achieving an area under the curve of 0.73 overall in twin pregnancy.
A risk prediction model of PE which combined maternal age, BMI, uE, and inhibin A was better early predictors than any individual marker twin pregnancy.
建立基于双胎妊娠孕妇初诊及中孕期血清标志物和母体外周血特征的子痫前期风险预测模型。
回顾性分析 2005 年 1 月至 2017 年 9 月在我院行中孕期母血清四联筛查的 532 例双胎妊娠孕妇的临床资料。采用 Logistic 回归分析方法分析孕妇初诊及中孕期血清标志物和母体外周血特征与子痫前期的相关性。
本研究共纳入 35 例子痫前期孕妇和 497 例正常孕妇。两组孕妇的年龄和体质量指数（BMI）差异无统计学意义，而两组孕妇的分娩孕周和胎盘重量差异有统计学意义（均 < 0.001，=0.005）。在母体外周血标志物中，子痫前期孕妇的抑制素 A 值明显高于无子痫前期孕妇（<0.001）。此外，我们使用孕妇年龄、BMI、uE 和抑制素 A 预测子痫前期，在双胎妊娠中，该模型的曲线下面积为 0.73。
本研究建立的预测双胎妊娠孕妇子痫前期风险的模型中，结合孕妇年龄、BMI、uE 和抑制素 A 预测子痫前期的能力优于任何单一标志物。
