Meyer R E, Thompson S J, Addy C L, Garrison C Z, Best R G
Department of Epidemiology and Biostatistics, University of South Carolina School of Public Health, Columbia 29203, USA.
Am J Obstet Gynecol. 1995 Jul;173(1):181-6. doi: 10.1016/0002-9378(95)90187-6.
The purpose of this study was to determine whether elevated midtrimester serum placental alkaline phosphatase levels are predictive of preterm delivery.
By use of banked serum specimens from a sample of women who had received maternal serum alpha-fetoprotein screening, placental alkaline phosphatase values for multiples of the median were obtained from 270 mothers who had experienced a preterm delivery and from 1598 mothers of term, appropriate-for-gestational-age infants. Specimens were analyzed for placental alkaline phosphatase by means of a monoclonal antibody enzyme-linked immunosorbent assay. Logistic regression was used to determine whether placental alkaline phosphatase was associated with preterm birth, while potential confounders were controlled for.
Women with placental alkaline phosphatase levels > or = 2.0 multiples of the median were significantly more likely to be delivered of a preterm infant in the current pregnancy compared with women with levels < 2.0 multiples of the median (odds ratio 2.9, 95% confidence interval 2.1 to 3.9). The likelihood of preterm birth increased significantly with higher multiples of the median (p < 0.001).
Women with elevated placental alkaline phosphatase levels are at increased risk for preterm delivery. Additional studies are needed to evaluate the clinical utility of placental alkaline phosphatase testing as a means of identifying mothers at risk for preterm birth.
本研究旨在确定孕中期血清胎盘碱性磷酸酶水平升高是否可预测早产。
利用接受母血清甲胎蛋白筛查的女性样本的储备血清标本，从270名早产母亲及1598名足月、适于胎龄婴儿的母亲中获取胎盘碱性磷酸酶值中位数倍数。通过单克隆抗体酶联免疫吸附测定法分析标本中的胎盘碱性磷酸酶。使用逻辑回归确定胎盘碱性磷酸酶是否与早产相关，同时控制潜在混杂因素。
与胎盘碱性磷酸酶水平<2.0中位数倍数的女性相比，胎盘碱性磷酸酶水平≥2.0中位数倍数的女性在本次妊娠中早产的可能性显著更高（比值比2.9，95%置信区间2.1至3.9）。中位数倍数越高，早产的可能性显著增加（p<0.001）。
胎盘碱性磷酸酶水平升高的女性早产风险增加。需要进一步研究评估胎盘碱性磷酸酶检测作为识别早产风险母亲手段的临床实用性。
