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探讨血清 afamin 浓度在诊断为晚期胎儿生长受限或胎儿小于胎龄孕妇中的变化。

Investigation of serum afamin concentration in pregnant women diagnosed with late fetal growth restriction or small for gestational age fetus.

机构信息

Department of Obstetrics and Gynecology, Umraniye Training and Research Hospital, Istanbul, Turkey.

Department of Obstetrics and Gynecology, Maternal Fetal Unit, Umraniye Training and Research Hospital, Istanbul, Turkey.

出版信息

J Matern Fetal Neonatal Med. 2023 Dec;36(2):2240468. doi: 10.1080/14767058.2023.2240468.

Abstract

OBJECTIVE

To investigate the afamin concentration in the serum of pregnant women diagnosed with late fetal growth restriction (FGR) or small for gestational age (SGA) in the third trimester.

METHODS

This prospective case-control study was conducted on 126 pregnant women, 42 of whom were diagnosed with late FGR in the third trimester, 43 were SGA, and 41 were healthy controls. The groups were compared in terms of maternal serum afamin concentrations.

RESULTS

Three groups were similar in terms of demographic characteristics and gestational age at blood sampling for afamin ( < .05). The median afamin concentration was determined as 199 ng/mL in the late FGR group, 153 ng/mL in the SGA group, and 108 ng/mL in the control group ( = .000). In the post-hoc analysis, while maternal serum afamin concentrations were found to be significantly higher in the late FGR group and SGA group compared to the control group but, this significance could not be shown between the FGR group and the SGA group ( = .00001,  = .005,  = .137, respectively). In the ROC analysis, the optimal cutoff value of serum afamin concentration to predict late FGR was determined as 141 ng/mL, with a sensitivity of 66.6% and a specificity of 85.3%.

CONCLUSIONS

The serum afamin concentration in the third trimester was found to be higher in pregnant women with late FGR compared to the SGA and control groups. Although afamin is seen as a promising molecule in the clinical prediction of late FGR, this needs to be supported by large series of studies.

摘要

目的

研究诊断为晚期胎儿生长受限(FGR)或小于胎龄儿(SGA)的孕妇在妊娠晚期血清中 afamin 的浓度。

方法

本前瞻性病例对照研究纳入了 126 名孕妇,其中 42 例在妊娠晚期被诊断为晚期 FGR,43 例为 SGA,41 例为健康对照组。比较了各组孕妇血清 afamin 浓度。

结果

三组孕妇的人口统计学特征和 afamin 采血时的孕龄无差异( < .05)。晚期 FGR 组的 afamin 中位数浓度为 199 ng/mL,SGA 组为 153 ng/mL,对照组为 108 ng/mL( = .000)。在事后分析中,与对照组相比,晚期 FGR 组和 SGA 组孕妇血清 afamin 浓度明显升高,但 FGR 组与 SGA 组之间无差异( = .00001, = .005, = .137)。在 ROC 分析中,血清 afamin 浓度预测晚期 FGR 的最佳截断值为 141 ng/mL,其敏感性为 66.6%,特异性为 85.3%。

结论

与 SGA 和对照组相比,晚期 FGR 孕妇妊娠晚期血清 afamin 浓度升高。虽然 afamin 作为晚期 FGR 临床预测的有前途的分子,但需要大系列研究的支持。

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