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子痫前期孕妇的 PAPP-A 值高于妊娠高血压孕妇。

Higher PAPP-A Values in Pregnant Women Complicated with Preeclampsia Than with Gestational Hypertension.

机构信息

El Bosque Research Group of Maternal Fetal Medicine and Gynecology, Universidad El Bosque, Bogotá, Colombia.

Ecodiagnóstico El Bosque S.A.S., Bogotá, Colombia.

出版信息

Reprod Sci. 2023 Aug;30(8):2503-2511. doi: 10.1007/s43032-023-01176-1. Epub 2023 Mar 14.

Abstract

The purpose of this study is to compare the levels of maternal serum pregnancy-associated plasma protein-A at the first trimester in pregnancies complicated by impaired placental diseases, such as preeclampsia (PE), intrauterine fetal growth restriction (IUGR), and gestational hypertension (GH), with those in pregnancies without the development of any of these outcomes to expand the knowledge of how this protein behaves in the different impaired placental diseases. This current work is an observational study based on a prospective cohort. Pregnancy-associated plasma protein-A was measured in 422 patients who had completed maternal-perinatal outcomes. Comparisons of pregnancy characteristics and the biomarker between outcome groups (PE, IUGR, gestational hypertension, and not impaired placental outcomes) were analyzed. PAPP-A MoM in the IUGR (0.8 IQR: 0.6-0.9) and GH groups (0.5 IQR: 0.3-1.4) compared to the PE group (1.06 IQR: 0.66-1.52) was significantly lower (p < 0.005). Pregnant women who developed early-onset PE (1.11 IQR 1.08-1.18) presented significant differences with the IUGR group (0.83 IQR: 0.59-0.98; p = 0.002) and those who developed preterm-PE (1.19 IQR: 0.66-1.58; p = 0.045). The results demonstrate that the levels of PAPP-A at first trimester in the sample of women who developed PE, and specially term-PE, were higher than those in women who developed GH or IUGR. The GH group had the lowest PAPP-A values in this sample of pregnant women. Research in a population with a high prevalence of preeclampsia is still lacking and deserves more extended studies to define if these patients could have different rates of PAPP-A.

摘要

本研究的目的是比较患有胎盘功能障碍性疾病(如子痫前期(PE)、胎儿宫内生长受限(IUGR)和妊娠期高血压(GH))的孕妇与未发生任何此类结局的孕妇在孕早期母体血清妊娠相关血浆蛋白-A (PAPP-A)水平,以扩展对这种蛋白在不同胎盘功能障碍性疾病中表现的认识。本研究是一项基于前瞻性队列的观察性研究。对已完成母婴围产期结局的 422 例患者进行了 PAPP-A 测量。对结局组(PE、IUGR、GH 和无胎盘功能障碍结局)的妊娠特征和生物标志物进行了比较分析。IUGR 组(0.8 IQR:0.6-0.9)和 GH 组(0.5 IQR:0.3-1.4)的 PAPP-A MoM 明显低于 PE 组(1.06 IQR:0.66-1.52)(p<0.005)。早发型 PE 孕妇(1.11 IQR 1.08-1.18)与 IUGR 组(0.83 IQR:0.59-0.98;p=0.002)和早产 PE 孕妇(1.19 IQR:0.66-1.58;p=0.045)有显著差异。结果表明,在发生 PE(特别是足月 PE)的妇女样本中,PAPP-A 在孕早期的水平高于发生 GH 或 IUGR 的妇女。GH 组的孕妇在该样本中 PAPP-A 值最低。仍缺乏子痫前期高发人群的研究,需要进一步扩展研究以确定这些患者是否具有不同的 PAPP-A 率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7252/10354109/8a200fcfc619/43032_2023_1176_Fig1_HTML.jpg

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