Prenatal Diagnosis Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Jinan Pediatric Research Institute, Qilu Children's Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
Medicine (Baltimore). 2023 Sep 1;102(35):e34762. doi: 10.1097/MD.0000000000034762.
This study aimed to explore the prenatal indicators in the second trimester of pregnancy and their association with chromosome abnormities (CA) to guide decisions toward invasive diagnostic procedures. Pregnant women who underwent prenatal screening and underwent amniocentesis in the second trimester in our Hospital between June 2017 and February 2019 were included in this retrospective cohort study. The reason for amniocentesis in prenatal screening and diagnoses was extracted from the charts. Finally, 3449 pregnant women were included. Of them, 181 were with CA confirmed by amniocentesis (i.e., the CA group), while 3268 were without CA (i.e., the non-CA group). Compared with the women in the non-CA group, those in the CA group were more likely to be older (30 [27,32] vs 29 [26,31], P < .001), had higher gestational weeks (20 [19,23] vs 19 [18,23], P = .008), an increased risk of advanced maternal age (AMA) (9.4% vs 2.2%, P < .001), had an increased risk of NIPT (IRN) (5.1% vs 1.9%, P < .001), had higher rates of a parental chromosome abnormality (PCA) (1.8% vs 0.9%, P = .002), and had increased risk of trisomy 21 (IRT21) (63.0% vs 45.3%, P < .001). AMA (OR = 4.22, 95% CI: 2.35-7.58, P < .001; AUC = 0.536), IRN (OR = 10.62, 95% CI: 6.66-16.94, P < .001; AUC = 0.589), PCA (OR = 4.77, 95% CI: 2.01-11.32, P < .001; AUC = 0.584), and IRT21 (OR = 0.67, 95% CI: 0.47-0.89, P = .008; AUC = 0.515) were independently associated with CA. AMA, IRN, IRT21, and PCA during the second trimester were independently associated with CA, but their predictive values for CA were relatively low. Combining those indicators may improve the predictive value.
本研究旨在探讨妊娠中期的产前指标及其与染色体异常(CA)的关系,以指导侵入性诊断程序的决策。本回顾性队列研究纳入了 2017 年 6 月至 2019 年 2 月期间在我院接受产前筛查并在妊娠中期进行羊膜穿刺术的孕妇。从图表中提取产前筛查和诊断羊膜穿刺术的原因。最终,共纳入 3449 名孕妇。其中,181 名经羊膜穿刺术证实存在 CA(即 CA 组),3268 名无 CA(即非 CA 组)。与非 CA 组相比,CA 组的孕妇年龄更大(30[27,32] vs 29[26,31],P<.001),孕周更长(20[19,23] vs 19[18,23],P=0.008),高龄产妇(AMA)风险更高(9.4% vs 2.2%,P<.001),非整倍体母体血清学筛查(NIPT)风险更高(5.1% vs 1.9%,P<.001),染色体异常父母(PCA)的风险更高(1.8% vs 0.9%,P=0.002),21 三体(IRT21)的风险更高(63.0% vs 45.3%,P<.001)。AMA(OR=4.22,95%CI:2.35-7.58,P<.001;AUC=0.536)、NIPT(OR=10.62,95%CI:6.66-16.94,P<.001;AUC=0.589)、PCA(OR=4.77,95%CI:2.01-11.32,P<.001;AUC=0.584)和 IRT21(OR=0.67,95%CI:0.47-0.89,P=0.008;AUC=0.515)与 CA 独立相关。妊娠中期的 AMA、IRN、IRT21 和 PCA 与 CA 独立相关,但对 CA 的预测值相对较低。联合这些指标可能会提高预测值。