Department of Laboratory Medicine, Maternity and Child Healthcare Hospital of Nanshan District, Shenzhen, China.
J Obstet Gynaecol Res. 2022 Jul;48(7):1721-1731. doi: 10.1111/jog.15259. Epub 2022 Apr 6.
To evaluate the value of the second-trimester fibronectin concentration, alone and in combination with other markers (e.g., mean arterial pressure, inhibin A), in the identification of women who subsequently develop severe preeclampsia.
For this prospective nested case-control study, serum from pregnant women (gestational age 15-22 weeks) who underwent routine Down syndrome screening was analyzed. The women were tracked to delivery and assigned to the severe preeclampsia or control group, according to whether they developed severe preeclampsia. Each woman who later developed severe preeclampsia was paired with five healthy women with pregnancies of similar gestational age (± 1 week). Fibronectin, inhibin A, human chorionic gonadotropin, placental growth factor, cysteine, and homocysteine concentrations were measured in 44 cases in the severe preeclampsia group and 220 cases in the control group. The body mass index and mean arterial pressure were calculated. All results were compared between the two groups. Logistic regression analysis and receiver operating characteristic curve construction were conducted for markers differing significantly between two groups.
The second-trimester fibronectin value was positively correlated with severe preeclampsia and predicted 67.7% of severe preeclampsia cases. The combination of fibronectin, inhibin A, and mean arterial pressure predicted 76.7% of severe preeclampsia cases; predictive values for combinations of fibronectin with mean arterial pressure or inhibin A were 75.4% and 74.6%, respectively. Combination with these other markers increased the predictive value of fibronectin. In addition, fibronectin was more powerful for the late severe preeclampsia and severe preeclampsia without fetal growth restriction subgroups.
The second-trimester fibronectin concentration can be used to predict severe preeclampsia.
评估中期纤维连接蛋白浓度单独或与其他标志物（如平均动脉压、抑制素 A）联合应用于识别随后发生重度子痫前期的女性的价值。
本前瞻性巢式病例对照研究分析了接受常规唐氏综合征筛查的孕妇（妊娠 15-22 周）的血清。根据是否发生重度子痫前期，对孕妇进行跟踪至分娩，并将其分为重度子痫前期组或对照组。每一位随后发生重度子痫前期的女性与 5 位妊娠年龄相似（±1 周）的健康女性配对。在重度子痫前期组的 44 例病例和对照组的 220 例病例中测量了纤维连接蛋白、抑制素 A、人绒毛膜促性腺激素、胎盘生长因子、半胱氨酸和同型半胱氨酸的浓度。计算了体重指数和平均动脉压。比较两组之间的所有结果。对两组之间差异显著的标志物进行逻辑回归分析和受试者工作特征曲线构建。
中期纤维连接蛋白值与重度子痫前期呈正相关，可预测 67.7%的重度子痫前期病例。纤维连接蛋白、抑制素 A 和平均动脉压的联合预测了 76.7%的重度子痫前期病例；纤维连接蛋白与平均动脉压或抑制素 A 的联合预测值分别为 75.4%和 74.6%。与其他标志物联合使用可提高纤维连接蛋白的预测价值。此外，纤维连接蛋白对晚期重度子痫前期和无胎儿生长受限的重度子痫前期亚组更具预测力。
中期纤维连接蛋白浓度可用于预测重度子痫前期。
