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早孕期 PAPP-A 水平与足月出生体重的相关性。

Correlation Between PAPP-A Levels Determined During the First Trimester and Birth Weight at Full-Term.

机构信息

Obstetrics and Gynecology, Santiago de Compostela University Clinical Hospital, A Coruña, Spain.

出版信息

Reprod Sci. 2023 Nov;30(11):3235-3242. doi: 10.1007/s43032-023-01270-4. Epub 2023 May 26.

Abstract

Foetal birth weight is an important determinant of perinatal health. For this reason, various methods have been investigated for estimating this weight during pregnancy. The aim of this study is to evaluate the possible relationship between full-term birth weight and pregnancy-associated plasma protein-A (PAPP-A) levels determined during the first trimester as part of combined screening for aneuploidy carried out in pregnant women. We carried out a single-centre study including pregnant women who were being followed up by the Obstetrics Service Care Units of the XXI de Santiago de Compostela e Barbanza Foundation, who gave birth from March 1, 2015, to March 1, 2017, and who had undergone their first-trimester combined chromosomopathy screening. The sample included a total of 2794 women. We found a significant correlation between MoM PAPP-A and foetal birth weight. When MoM PAPP-A was measured at extremely low levels (< 0.3) during the first trimester, the OR for giving birth to a foetus with weight < p10, adjusting for gestational age and sex, was 2.74. For low levels of MoM PAPP-A (0.3-0.44), the OR was 1.52. With regard to the value of MOM PAPP-A levels as a predictor of foetal macrosomia, a correlation could be observed with elevated levels, although this was not statistically significant. PAPP-A determined during the first trimester acts as a predictor of foetal weight at term as well as for foetal growth disorders.

摘要

胎儿出生体重是围产期健康的重要决定因素。因此,人们研究了各种方法来估计怀孕期间的胎儿体重。本研究旨在评估在孕妇中进行的联合筛查中,在孕早期确定的足月出生体重与妊娠相关血浆蛋白 A(PAPP-A)水平之间可能存在的关系。我们进行了一项单中心研究,纳入了 2015 年 3 月 1 日至 2017 年 3 月 1 日期间在萨克拉门托德孔波斯特拉和巴尔班萨基金会的妇产科服务单位接受随访并分娩的孕妇,这些孕妇接受了联合筛查以检测染色体病。样本共包括 2794 名女性。我们发现 MoM PAPP-A 与胎儿出生体重之间存在显著相关性。当孕早期 MoM PAPP-A 极低(<0.3)时,调整胎龄和性别后,出生体重<p10 的胎儿的 OR 为 2.74。对于 MoM PAPP-A 低水平(0.3-0.44),OR 为 1.52。至于 MoM PAPP-A 水平作为胎儿巨大儿的预测值,虽然没有统计学意义,但可以观察到与升高水平相关。孕早期确定的 PAPP-A 可作为足月胎儿体重和胎儿生长障碍的预测指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f0c6/10643350/a2b5e1d6615c/43032_2023_1270_Fig1_HTML.jpg

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