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常规产前筛查中使用的血清标志物与妊娠结局的关联:一项队列研究。

Association Between Serum Markers Used in the Routine Prenatal Screening with Pregnancy Outcomes: A Cohort Study.

作者信息

Alizadeh-Dibazari Zohreh, Alizadeh-Ghodsi Zahra, Fathnezhad-Kazemi Azita

机构信息

Obstetrician, Instructor, Department of Midwifery, Faculty of Nursing and Midwifery, Islamic Azad University, Tabriz branch, Tabriz, Iran.

Bachelor midwifery student, Student Research Committee, Islamic Azad University, Tabriz branch, Tabriz, Iran.

出版信息

J Obstet Gynaecol India. 2022 Aug;72(Suppl 1):6-18. doi: 10.1007/s13224-021-01508-8. Epub 2021 Aug 6.

Abstract

BACKGROUND

Early detection of adverse pregnancy outcomes is an important topic in prenatal care. This study aimed to evaluate the association between maternal serum markers and pregnancy outcomes.

MATERIALS AND METHODS

This hospital-based cohort study was performed according to the national Down syndrome screening protocol on 2923 eligible pregnant women. Pregnancies were classified into three groups of based on each biomarker. The participants were followed up until delivery, and the pregnancy outcomes were identified by hospital discharge records.

RESULTS

High levels of free BHCG were significantly associated with an increased risk of preterm birth ( = - 0.31, SE = 0.158, OR = 0.730; = 0.046). Based on multivariate analysis the high levels of MSAFP had a direct relationship with premature birth (= - 0.84, SE = 0.361, OR = 0.431, = 0.020), gestational hypertension (= - 0.59, SE = 0.354, OR = 0.549. = 0.091), IUGR (= - 1.46, SE = 0.433, OR = 0.231, = 0.001), and fetal death (= - 1.50, SE = 0.533, OR = 0.223, = 0.005). Furthermore, an increase in the levels of Inhibin-A could more likely lead to gestational hypertension (= - 0.63, SE = 0.235, OR = 0.533).

DISCUSSION

According to the result, maternal biomarkers, especially MSAFP, can be beneficial in identifying high-risk cases, in addition to examining the possibility of Down syndrome, facilitating achievement of the desired pregnancy outcomes.

摘要

背景

不良妊娠结局的早期检测是产前护理中的一个重要课题。本研究旨在评估母体血清标志物与妊娠结局之间的关联。

材料与方法

本基于医院的队列研究按照国家唐氏综合征筛查方案对2923名符合条件的孕妇进行。根据每种生物标志物将妊娠分为三组。对参与者进行随访直至分娩,并通过医院出院记录确定妊娠结局。

结果

游离β-人绒毛膜促性腺激素(free BHCG)水平升高与早产风险增加显著相关(β = -0.31,标准误 = 0.158,比值比 = 0.730;P = 0.046)。基于多变量分析,甲胎蛋白(MSAFP)水平升高与早产(β = -0.84,标准误 = 0.361,比值比 = 0.431,P = 0.020)、妊娠期高血压(β = -0.59,标准误 = 0.354,比值比 = 0.549,P = 0.091)、胎儿生长受限(IUGR)(β = -1.46,标准误 = 0.433,比值比 = 0.231,P = 0.001)和胎儿死亡(β = -1.50,标准误 = 0.533,比值比 = 0.223,P = 0.005)有直接关系。此外,抑制素A水平升高更可能导致妊娠期高血压(β = -0.63,标准误 = 0.235,比值比 = 0.533)。

讨论

根据结果,母体生物标志物,尤其是甲胎蛋白,除了用于检测唐氏综合征的可能性外,在识别高危病例方面可能有益,有助于实现理想的妊娠结局。

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本文引用的文献

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Maternal Serum Aneuploidy Screen and Adverse Pregnancy Outcomes.母血清非整倍体筛查与不良妊娠结局
J Obstet Gynaecol India. 2016 Oct;66(Suppl 1):141-8. doi: 10.1007/s13224-015-0826-2. Epub 2016 Mar 11.

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