高磷酸化胰岛素样生长因子结合蛋白-1及宫颈长度对双胎妊娠早产预测的意义
Significance of highly phosphorylated insulin-like growth factor binding protein-1 and cervical length for prediction of preterm delivery in twin pregnancies.
作者信息
Lan Rui-Hong, Song Jie, Gong Hu-Min, Yang Yang, Yang Hong, Zheng Lin-Mei
机构信息
Department of Obstetrics, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou 570311, Hainan Province, China.
出版信息
World J Clin Cases. 2021 Jun 26;9(18):4553-4558. doi: 10.12998/wjcc.v9.i18.4553.
BACKGROUND
A twin pregnancy can carry greater risks than singleton pregnancies. About 60 in 100 twin pregnancies result in spontaneous birth before 37 wk, which is associated with several complications in the premature babies. Clinical detection of biomarkers may help to predict the possibility of premature birth so that corresponding interventions can be given to the pregnant women in a timely manner, in order to reduce the risk of preterm birth and improve the outcomes of the newborn infants.
AIM
To explore the clinical value of transvaginal ultrasound measurement of cervical length combined with insulin-like growth factor binding protein-1 (IGFBP-1) hyperphosphorylation in cervical secretions as predictors of preterm delivery in twin pregnancies.
METHODS
A total of 254 pregnant women with twin pregnancies, who were admitted to Hainan General Hospital and underwent maternity examination, were selected as the study subjects from January 2015 to December 2018. All participants received transvaginal ultrasound measurement of cervical length and phosphorylated IGFBP-1 (phIGFBP-1) test between 24 and 34 wk gestation. The pregnancy outcomes were analyzed.
RESULTS
Of the women with a positive phIGFBP-1 test result, preterm birth rate was higher in those with a cervical length ≤ 25 mm than those with a cervical length > 25 mm (all < 0.05). Similarly, in women with a negative phIGFBP-1 test result, preterm birth rate was higher in those with a cervical length ≤ 25 mm than those with a cervical length > 25 mm (all < 0.05). The sensitivity, specificity, and positive and negative predictive values of the phIGFBP-1 test combined with the cervical length test were 95.71%, 91.21%, 95.12% and 92.22%, respectively, for the prediction of preterm birth.
CONCLUSION
Cervical length combined with phIGFBP-1 tests is of value for the prediction of outcomes of preterm delivery in twin pregnancies.
背景
双胎妊娠比单胎妊娠风险更高。每100例双胎妊娠中约有60例会在37周前自然分娩，这与早产儿的多种并发症相关。生物标志物的临床检测可能有助于预测早产的可能性，以便及时对孕妇采取相应干预措施，降低早产风险，改善新生儿结局。
目的
探讨经阴道超声测量宫颈长度联合宫颈分泌物中胰岛素样生长因子结合蛋白-1（IGFBP-1）高磷酸化对双胎妊娠早产的预测价值。
方法
选取2015年1月至2018年12月在海南医学院第一附属医院接受产检的254例双胎妊娠孕妇作为研究对象。所有参与者在妊娠24至34周期间接受经阴道超声测量宫颈长度及磷酸化IGFBP-1（phIGFBP-1）检测。分析妊娠结局。
结果
phIGFBP-1检测结果为阳性的孕妇中，宫颈长度≤25 mm者的早产率高于宫颈长度>25 mm者（均P<0.05）。同样，phIGFBP-1检测结果为阴性的孕妇中，宫颈长度≤25 mm者的早产率高于宫颈长度>25 mm者（均P<0.05）。phIGFBP-1检测联合宫颈长度检测预测早产的灵敏度、特异度、阳性预测值和阴性预测值分别为95.71%、91.21%、95.12%和92.22%。
结论
宫颈长度联合phIGFBP-1检测对预测双胎妊娠早产结局具有价值。
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