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越南北方胎儿颈部半透明层厚度增加与染色体缺陷之间的关系。

Relation Between Increased Fetal Nuchal Translucency Thickness and Chromosomal Defects in Northern Vietnam.

作者信息

Hai Long Nguyen, Danh Cuong Tran, Toan Anh Ngo

机构信息

Department of Obstetrics, Haiphong Hospital of Obstetrics and Gynecology, Haiphong, VNM.

Department of Obstetrics and Gynecology, Hanoi Medical University, Hanoi, VNM.

出版信息

Cureus. 2021 Oct 2;13(10):e18446. doi: 10.7759/cureus.18446. eCollection 2021 Oct.

Abstract

Objective To examine the prevalence of all chromosomal defects amongst fetuses with increased nuchal translucency thickness (NT). Methods This is a retrospective study amongst pregnant women indicated for amniocentesis by nuchal translucency above 3.0 mm and consent to the study. A total of 2,720 cases were recruited during the six-year period from 2015 to 2020. All singleton pregnancies were offered fetal karyotype when the fetal nuchal translucency was ≥2.5 mm. The prevalence of chromosomal defects was divided into five NT categories: 2.5-3.4 mm, 3.5-4.4 mm, 4.5-5.4 mm, 5.5-6.4 mm, ≥6.5 mm. Results The study identified 2,720 amniocentesis for increased NT. The mean maternal age was 29.19 (range 17-46) years, and the mean fetal crown-rump length was 66.9 (range 45-84) mm. The fetal karyotype was abnormal in 560 (20.6%) participants. The most frequent chromosomal disorders were trisomy 21 (55%), trisomy 18 (11.2%), trisomy 13 (3.9%), 45,XO (2.7%). The prevalence of chromosomal aberrations was ranged from 17.9% (NT between 2.5-3.4 mm) to 29.7% (NT≥6.5 mm). A majority of fetuses with trisomy 13, 18, or 21 has NT measurement lower than 5.5 mm. In those with Turner syndrome, there was no difference between the group with NT <5.5 mm and the group with NT ≥5.5 mm. Increased maternal age is a risk factor for chromosomal aberrations with the rate increased from 17.6% at the youngest maternal age of 30-34 to 34% at maternal age of 35-39 and to 50% at maternal age of ≥40. Conclusion In fetuses with increased NT, more than a half of the chromosomal abnormalities were affected by defects other than trisomy 21. The distribution of NT was different between Turner syndrome and trisomy 13, 18, 21 syndromes. Women aged 35 years or older had a higher risk of chromosomal aberrations.

摘要

目的 研究颈部半透明层厚度(NT)增加的胎儿中所有染色体缺陷的患病率。方法 这是一项对因NT超过3.0 mm而接受羊膜穿刺术且同意参与研究的孕妇进行的回顾性研究。在2015年至2020年的六年期间共招募了2720例病例。当胎儿颈部半透明层厚度≥2.5 mm时,所有单胎妊娠均进行胎儿核型分析。染色体缺陷的患病率分为五个NT类别:2.5 - 3.4 mm、3.5 - 4.4 mm、4.5 - 5.4 mm、5.5 - 6.4 mm、≥6.5 mm。结果 该研究确定了2720例因NT增加而进行的羊膜穿刺术。孕妇平均年龄为29.19岁(范围17 - 46岁),胎儿头臀长度平均为66.9 mm(范围45 - 84 mm)。560名(20.6%)参与者的胎儿核型异常。最常见的染色体疾病是21三体(55%)、18三体(11.2%)、13三体(3.9%)、45,XO(2.7%)。染色体畸变的患病率范围为17.9%(NT在2.5 - 3.4 mm之间)至29.7%(NT≥6.5 mm)。大多数13三体、18三体或21三体胎儿的NT测量值低于5.5 mm。在特纳综合征患者中,NT <5.5 mm组和NT≥5.5 mm组之间没有差异。孕妇年龄增加是染色体畸变的一个危险因素,患病率从最年轻的30 - 34岁孕妇的17.6%增加到35 - 39岁孕妇的34%,再到≥40岁孕妇的50%。结论 在NT增加的胎儿中,超过一半的染色体异常是由21三体以外的缺陷引起的。特纳综合征与13三体、18三体、21三体综合征的NT分布不同。35岁及以上的女性染色体畸变风险更高。

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