Abotorabi Shokoh, Moeini Niloufar, Moghbelinejad Sahar
Department of Obstetrics and Gynecology, School of Medicine, Qazvin University of Medical Science, Qazvin, Iran.
Department of Biology, School of Basic Science, Qom Islamic Azad University, Qom, Iran.
J Family Reprod Health. 2020 Jun;14(2):81-87. doi: 10.18502/jfrh.v14i2.4349.
The purpose of this study was comparison of association of three main first trimester screening factors with pregnancy outcomes among Iranian pregnant women. This prospective study was done during 2017-2019 years in Qazvin, Iran. To do so, a total of 1500pregnant women in first trimester were enrolled. At the first step, Nuchal translucency (NT) was measured in 11-13 ± 5 week, then the serum pregnancy-associated plasma protein A (PAPP-A) and free-β-human chorionic gonadotropin (free-β-HCG) were measured in 12-14 weeks of gestation. Pregnant women were followed up until the end of pregnancy for the complications of pregnancy such as intra-uterine growth retardation (IUGR), intrauterine death (IUFD), different types of fetal loss and preterm labor. The results showed that low levels of serum biomarkers had more association with pregnancy complications in comparison to high levels of them. Significant association of IUGR (P = 0.001), IUFD (P = 0.032) and pre-term labor (P = 0.002) was shown in women with low serum levels of PAPP-A in comparison to low serum levels of free-β-hCG. Significant high frequency of different types of fetal loss (IUFD, Abortion, Elective termination) was shown in fetuses with N ≥ 3 in comparison to low levels of serum biomarkers (P = 0.001). This study highlighted the importance of accurately interpreting the results of the first trimester of pregnancy screening which should be considered by primatologists for subsequent pregnancy care.
本研究的目的是比较伊朗孕妇孕早期三项主要筛查因素与妊娠结局之间的关联。这项前瞻性研究于2017年至2019年在伊朗加兹温进行。为此,共纳入了1500名孕早期孕妇。第一步,在孕11至13⁺⁵周测量颈部透明带(NT),然后在妊娠12至14周测量血清妊娠相关血浆蛋白A(PAPP-A)和游离β-人绒毛膜促性腺激素(游离β-HCG)。对孕妇进行随访直至妊娠结束,观察妊娠并发症,如宫内生长受限(IUGR)、宫内死亡(IUFD)、不同类型的胎儿丢失和早产。结果表明,与血清生物标志物高水平相比,低水平与妊娠并发症的关联更强。与游离β-HCG低血清水平相比,PAPP-A低血清水平的女性中IUGR(P = 0.001)、IUFD(P = 0.032)和早产(P = 0.002)的关联显著。与血清生物标志物低水平相比,NT≥3的胎儿中不同类型胎儿丢失(IUFD、流产、选择性终止妊娠)的发生率显著更高(P = 0.001)。本研究强调了准确解读孕早期筛查结果的重要性,灵长类动物学家在后续妊娠护理中应予以考虑。