Department of Obstetrics and Gynecology, Jichi Medical University School of Medicine, Tochigi, Japan.
Department of Food and Health Sciences, Jissen Women's University, Tokyo, Japan.
J Obstet Gynaecol Res. 2021 Mar;47(3):1040-1051. doi: 10.1111/jog.14636. Epub 2021 Jan 5.
Our aim was to examine whether serum levels of placental growth factor (PlGF) and soluble endoglin (sEng) at 19-25 and 26-31 weeks of gestation were associated with the occurrence of the 9-block categorization of placenta weight (PW) and fetal/placenta ratio (F/P ratio).
We performed a retrospective cohort study in 1391 women with singleton pregnancy. Serum levels of PlGF and sEng were measured by enzyme immunosorbent assay. A light placenta was defined as PW ZS < -1.28 SD. Based on the PW (light, normal, and heavy) and F/P ratio (relatively heavy, balanced growth, and relatively small), 9-block categorization were performed. Multivariable logistic regression analyses were performed.
Low PlGF at 26-31 weeks was an independent risk factor for the birth of infants belonging to Block A (light placenta and relatively heavy infant), after adjusting for prepregnancy body mass index and serum levels of sEng. High sEng at 26-31 weeks was an independent risk factor for the birth of infants belonging to Block D (light placenta and balanced growth of infant), after adjusting for past history of either preeclampsia or gestational hypertension, high pulsatility index of uterine artery flow velocity waveforms in the second trimester, and serum level of PlGF.
Low PlGF levels at 26-31 weeks of gestation may precede a light placenta and relatively heavy infant (Block A), and high sEng levels at 26-31 weeks of gestation may precede a light placenta and balanced growth of infant (Block D).
本研究旨在探讨孕 19-25 周和 26-31 周时血清胎盘生长因子(PlGF)和可溶性内皮糖蛋白(sEng)水平与胎盘重量(PW)和胎儿/胎盘比(F/P 比)的 9 块分类的发生是否相关。
我们对 1391 例单胎妊娠女性进行了回顾性队列研究。采用酶联免疫吸附法测定血清 PlGF 和 sEng 水平。将胎盘重量 Z 评分(PW ZS)< -1.28 SD 定义为轻型胎盘。根据 PW(轻型、正常和重型)和 F/P 比(相对重型、平衡生长和相对小型)进行 9 块分类。采用多变量逻辑回归分析。
校正孕前体重指数和 sEng 血清水平后,孕 26-31 周时 PlGF 水平较低是婴儿属于 A 块(轻型胎盘和相对重型婴儿)的独立危险因素。校正子痫前期或妊娠期高血压病史、中孕期子宫动脉血流速度搏动指数和 PlGF 血清水平后,孕 26-31 周时 sEng 水平较高是婴儿属于 D 块(轻型胎盘和平衡生长婴儿)的独立危险因素。
孕 26-31 周时 PlGF 水平较低可能预示着轻型胎盘和相对重型婴儿(A 块),而孕 26-31 周时 sEng 水平较高可能预示着轻型胎盘和平衡生长婴儿(D 块)。