Okai Charles A, Russ Manuela, Wölter Manja, Andresen Kristin, Rath Werner, Glocker Michael O, Pecks Ulrich
Proteome Center Rostock, University Medicine and Natural Science Faculty, University of Rostock, 18051 Rostock, Germany.
Department of Obstetrics and Gynecology, Medical Faculty, University of Rostock, Clinic Südstadt, 18059 Rostock, Germany.
J Clin Med. 2020 May 7;9(5):1374. doi: 10.3390/jcm9051374.
Fetal growth restriction (FGR) affects about 3% to 8% of pregnancies, leading to higher perinatal mortality and morbidity. Current strategies for detecting fetal growth impairment are based on ultrasound inspections. However, antenatal detection rates are insufficient and critical in countries with substandard care. To overcome difficulties with detection and to better discriminate between high risk FGR and low risk small for gestational age (SGA) fetuses, we investigated the suitability of risk assessment based on the analysis of a recently developed proteome profile derived from maternal serum in different study groups. Maternal serum, collected at around 31 weeks of gestation, was analyzed in 30 FGR, 15 SGA, and 30 control (CTRL) pregnant women who delivered between 31 and 40 weeks of gestation. From the 75 pregnant women of this study, 2 were excluded because of deficient raw data and 2 patients could not be grouped due to indeterminate results. Consistency between proteome profile and sonography results was obtained for 59 patients (26 true positive and 33 true negative). Of the proteome profiling 12 contrarious grouped individuals, 3 were false negative and 9 were false positive cases with respect to ultrasound data. Both true positive and false positive grouping transfer the respective patients to closer surveillance and thorough pregnancy management. Accuracy of the test is considered high with an area-under-curve value of 0.88 in receiver-operator-characteristics analysis. Proteome profiling by affinity-mass spectrometry during pregnancy provides a reliable method for risk assessment of impaired development in fetuses and consumes just minute volumes of maternal peripheral blood. In addition to clinical testing proteome profiling by affinitymass spectrometry may improve risk assessment, referring pregnant women to specialists early, thereby improving perinatal outcomes.
胎儿生长受限(FGR)影响约3%至8%的妊娠,导致围产期死亡率和发病率升高。目前检测胎儿生长受损的策略基于超声检查。然而,在医疗水平不达标的国家,产前检测率不足且至关重要。为了克服检测困难并更好地区分高风险FGR和低风险小于胎龄(SGA)胎儿,我们在不同研究组中研究了基于分析最近从母体血清中开发的蛋白质组图谱进行风险评估的适用性。对30例FGR孕妇、15例SGA孕妇和30例对照(CTRL)孕妇在妊娠31周左右采集的母体血清进行分析,这些孕妇在妊娠31至40周之间分娩。在本研究的75名孕妇中,2名因原始数据不足被排除,2名患者因结果不确定无法分组。59例患者(26例真阳性和33例真阴性)的蛋白质组图谱与超声检查结果一致。在蛋白质组分析的12例分组不一致的个体中,相对于超声数据,3例为假阴性,9例为假阳性。真阳性和假阳性分组都会将相应患者转至更密切的监测和全面的妊娠管理。在受试者操作特征分析中,该检测的曲线下面积值为0.88,认为检测准确性较高。孕期通过亲和质谱进行蛋白质组分析为胎儿发育受损的风险评估提供了一种可靠的方法,且仅消耗微量的母体外周血。除了临床检测外,通过亲和质谱进行蛋白质组分析可能会改善风险评估,尽早将孕妇转诊给专家,从而改善围产期结局。