Department of Laboratory, Guangzhou Women and Children's Medical Centre, Guangzhou Medical University, No. 9 Jinsui Road, Guangzhou, 510623, China.
School of Public Health, Guangzhou Medical University, Panyu District, Guangzhou, 511436, China.
Arch Gynecol Obstet. 2022 Sep;306(3):723-734. doi: 10.1007/s00404-021-06335-w. Epub 2021 Nov 24.
The study aimed to investigate the potential risk factors for the placenta accreta spectrum (PAS), determine the predictive value of a diagnostic model, and evaluate the effects of octamethylcyclotetrasiloxane (OMCTS) on trophoblast proliferation and migration.
This case-control study included 244 pregnant women with PAS and 327 normal pregnant women who visited Guangzhou Women and Children's Medical Centre, China, from January 2014 to December 2017. Blood was collected from 42 women with PAS and 77 controls, and plasma specimens were analyzed by gas chromatography-time-of-flight mass spectrometry. In addition, the proliferation and migration of trophoblast cells were examined after treatment with OMCTS.
We found an association between the risk of PAS and clinical factors related to fasting blood glucose levels (BS0, OR = 5.78), as well as factors related to endometrial injury [history of cesarean section (OR = 179.59), uterine scarring (OR = 68.37), and history of abortion (OR = 5.66)]. Equally important, pregnant women with PAS had significantly higher plasma OMCTS concentrations than controls. In vitro, we found that OMCTS could promote the proliferation and migration of HTR8/SVneo cells. The model of combining clinical factors and OMCTS had a good performance in PAS prediction (AUC = 0.97, 95% CI 0.78-0.93).
The early diagnosis of PAS in pregnant women requires assessing risk factors, metabolic status, and BS0 levels before 20 weeks of gestation. OMCTS may be related to the development of PAS by promoting trophoblast cell proliferation and migration.
本研究旨在探讨胎盘部位滋养细胞肿瘤谱（PAS）的潜在危险因素，确定诊断模型的预测价值，并评估八甲基环四硅氧烷（OMCTS）对滋养细胞增殖和迁移的影响。
这项病例对照研究纳入了 2014 年 1 月至 2017 年 12 月在中国广州妇女儿童医疗中心就诊的 244 例 PAS 孕妇和 327 例正常孕妇。采集了 42 例 PAS 孕妇和 77 例对照者的血液，并通过气相色谱-飞行时间质谱分析血浆标本。此外，还研究了 OMCTS 处理后滋养细胞的增殖和迁移情况。
我们发现，PAS 的发病风险与空腹血糖水平（BS0）相关的临床因素（OR=5.78）以及与子宫内膜损伤相关的因素（剖宫产史（OR=179.59）、子宫瘢痕（OR=68.37）和流产史（OR=5.66））有关。同样重要的是，PAS 孕妇的血浆 OMCTS 浓度明显高于对照组。在体外，我们发现 OMCTS 可促进 HTR8/SVneo 细胞的增殖和迁移。结合临床因素和 OMCTS 的模型在 PAS 预测中具有良好的性能（AUC=0.97，95%CI 0.78-0.93）。
在妊娠 20 周前评估孕妇的 PAS 风险需要评估危险因素、代谢状态和 BS0 水平。OMCTS 可能通过促进滋养细胞增殖和迁移而与 PAS 的发生有关。
