Capriglione Stella, Gulino Ferdinando Antonio, Latella Silvia, De Felice Giovanna, Filippini Maurizio, Farinelli Miriam, Martire Francesco Giuseppe, Viora Elsa
Department of Obstetrics and Gynecology, Ospedale "Santa Maria Alla Gruccia" Piazza del Volontariato 2, 52025 Montevarchi, Italy.
Department of Obstetrics and Gynecology, Azienda di Rilievo Nazionale e Alta Specializzazione (ARNAS) Garibaldi, Via Palermo 636, 95126 Catania, Italy.
J Clin Med. 2022 Aug 4;11(15):4555. doi: 10.3390/jcm11154555.
The study aimed to evaluate the ability defining the risk of developing preeclampsia by a screening test carried out in the first trimester (between 11 + 0 and 13 + 6 weeks of gestational age), in order to identify high-risk women requiring more intensive health surveillance. The secondary objective was to evaluate the ability of this test to predict the risk of adverse obstetric outcomes such as fetal growth restriction, intrauterine fetal death, gestational hypertension, HELLP syndrome, placental abruption, and preterm birth.
This was a single-center study, conducted at the Operative Unit of Obstetrics of the State Hospital of the Republic of San Marino. Medical history was collected at the time of enrolment in writing. Subsequently, obstetric outcomes were collected for each enrolled woman, through the analysis of medical records.
From October 2014 to May 2019, 589 pregnant women were recruited, of whom, 474 (80.5%) were included in the "low-risk" group, and 115 (19.5%) in the "high-risk" group. At the time of analysis of this population, the obstetric outcomes were available for 498 women (84.5%), while 91 cases (15.5%) were current pregnancies. The PI of the uterine arteries was not significantly different between the two study groups. Otherwise, a significant difference was highlighted for MAP, which is higher in the case of pregnancies at high risk based on the risk factors only, and for PAPP-A, higher in the case of low-risk pregnancies. Regarding the percentage of fetal DNA, according to the most recent literature data, in our series, we report a statistically significant difference of the average between the low and high-risk groups.
In our study, we demonstrate that the multiparametric screening test for early PE performed well in identifying women at high risk of early PE, which certainly has the most severe maternal-fetal outcomes. The data reported that ASA intake at low doses is significantly higher in the population with high-risk tests for both early PE and late PE suggest once again that anamnestic evaluation plays an essential role in women's screening.
本研究旨在评估通过孕早期（孕11⁺⁰至13⁺⁶周）进行的筛查试验来确定发生子痫前期风险的能力，以便识别需要更强化健康监测的高危女性。次要目的是评估该试验预测不良产科结局风险的能力，这些不良产科结局包括胎儿生长受限、胎儿宫内死亡、妊娠期高血压疾病、HELLP综合征、胎盘早剥和早产。
这是一项在圣马力诺共和国国立医院产科手术单元开展的单中心研究。在入组时以书面形式收集病史。随后，通过分析病历为每位入组女性收集产科结局。
2014年10月至2019年5月，招募了589名孕妇，其中474名（80.5%）被纳入“低风险”组，115名（19.5%）被纳入“高风险”组。在对该人群进行分析时，498名女性（84.5%）有产科结局数据，而91例（15.5%）为当前妊娠。两组研究对象子宫动脉搏动指数无显著差异。否则，平均动脉压（MAP）存在显著差异，仅基于风险因素的高危妊娠时MAP较高，妊娠相关血浆蛋白A（PAPP-A）在低风险妊娠时较高。关于胎儿DNA百分比，根据最新文献数据，在我们的系列研究中，低风险组和高风险组之间的平均值存在统计学显著差异。
在我们的研究中，我们证明了早期子痫前期的多参数筛查试验在识别早期子痫前期高危女性方面表现良好，而早期子痫前期肯定具有最严重的母婴结局。数据表明，早期子痫前期和晚期子痫前期高危检测人群中低剂量阿司匹林的摄入量显著更高，这再次表明既往史评估在女性筛查中起着至关重要的作用。
