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对有先兆流产风险的孕妇的血清血液参数和淀粉样蛋白 A 水平进行评估。

An evaluation of serum blood parameters and amyloid A levels in pregnant women with threatened miscarriage.

机构信息

Department of Obstetrics and Gynecology, Antalya Training and Research Hospital, Antalya, Turkey.

Department of Obstetrics and Gynecology, Aydın Child and Women Hospital, Aydın, Turkey.

出版信息

Am J Reprod Immunol. 2024 Mar;91(3):e13829. doi: 10.1111/aji.13829.

Abstract

OBJECTIVE

This study investigated whether serum amyloid A (AA) levels can be used as a biomarker in patients with threatened abortion.

MATERIAL AND METHODS

This prospective cohort study was conducted at the Antalya Training and Research Hospital, Department of Obstetrics and Gynecology, Türkiye, between April and October 2023. Eighty-eight pregnant women, 44 diagnosed with threatened miscarriage (Group 1) and 44 healthy individuals (Group 2), were included in the study. Sociodemographic, obstetric, and laboratory parameters were compared between the groups.

RESULTS

No statistically significant differences were observed between the groups in terms of sociodemographic data (age, body mass index, education level, economic status, occupation status, smoking, and alcohol consumption). However, obstetric characteristics (number of pregnancies, living children, miscarriages, dilatation and curettage, gestational age on admission, and fetal crown-rump length) and laboratory values including complete blood count, hematocrit, leukocyte, neutrophil, lymphocytes, platelet, hs-C-reactive protein, neutrophil-lymphocyte and platelet-lymphocyte ratio (p > .05), and serum AA values (7.49 ± 3.07 in Group 1 vs. 9.46 ± 4.80 in Group 2, p = .024) differed significantly. Receiver operating characteristic analysis showed that the area under the curve (AUC: 0.662) was statistically significant for serum AA (p = .032), with a cut-off value of ≥7.51 (95% [confidence interval] 0.516-0.749, sensitivity 65%, specificity 51%). The positive predictive value of serum AA for threatened miscarriage was 56.8%, and the negative predictive value 59.4%.

CONCLUSION

This study shows that serum AA can be used as a biomarker in the diagnosis of threatened miscarriage. Prospective studies involving more participants are now needed to confirm our results.

摘要

目的

本研究旨在探讨血清淀粉样蛋白 A(AA)水平能否作为先兆流产患者的生物标志物。

材料和方法

本前瞻性队列研究于 2023 年 4 月至 10 月在土耳其安塔利亚培训和研究医院妇产科进行。纳入 88 例孕妇,其中 44 例诊断为先兆流产(第 1 组),44 例健康个体为对照组(第 2 组)。比较两组的社会人口学、产科和实验室参数。

结果

两组在社会人口学数据(年龄、体重指数、教育程度、经济状况、职业状况、吸烟和饮酒)方面无统计学差异。然而,产科特征(妊娠次数、活产子女数、流产次数、扩张刮宫术、入院时的孕周和胎儿头臀长)和实验室值(包括全血细胞计数、血细胞比容、白细胞、中性粒细胞、淋巴细胞、血小板、高敏 C 反应蛋白、中性粒细胞/淋巴细胞和血小板/淋巴细胞比值)以及血清 AA 值(第 1 组为 7.49±3.07,第 2 组为 9.46±4.80,p=0.024)差异有统计学意义。受试者工作特征分析显示,血清 AA 的曲线下面积(AUC:0.662)具有统计学意义(p=0.032),截断值≥7.51(95%[置信区间]0.516-0.749,敏感性 65%,特异性 51%)。血清 AA 对先兆流产的阳性预测值为 56.8%,阴性预测值为 59.4%。

结论

本研究表明,血清 AA 可作为先兆流产的生物标志物。目前需要更多参与者的前瞻性研究来证实我们的结果。

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