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孕中期羊水或母血清白细胞介素-10水平与小于胎龄儿

Second-trimester amniotic fluid or maternal serum interleukin-10 levels and small for gestational age neonates.

作者信息

Spong C Y, Sherer D M, Ghidini A, Jenkins C B, Seydel F D, Eglinton G S

机构信息

Department of Obstetrics and Gynecology, Georgetown University Medical Center, Washington, DC, USA.

出版信息

Obstet Gynecol. 1996 Jul;88(1):24-8. doi: 10.1016/0029-7844(96)00110-X.

Abstract

OBJECTIVE

To evaluate if interleukin-10 levels in either early second-trimester amniotic fluid (AF) or maternal serum can be utilized as a predictor of the subsequent occurrence of small for gestational age (SGA) infants after controlling for gestational age at delivery.

METHODS

We identified patients who underwent genetic amniocentesis for standard genetic indications or maternal blood sampling for maternal serum alpha-fetoprotein (MSAFP)/triple screen between January 1992 and February 1995 with available follow-up delivery data. Small for gestational age was defined as birth weight less than the tenth percentile for gestational age. Control patients were matched for gestational age at delivery, maternal age, race, and parity with at least two controls for each study patient. We excluded patients with maternal immune disease, chronic hypertension, diabetes, asthma, congenital heart disease, multiple gestation, and fetuses with structural or chromosomal anomalies. Second-trimester AF and serum samples were assayed for interleukin-10. Potential confounding variables considered were MSAFP level, smoking history, pregnancy-induced hypertension, and neonatal gender. The interleukin-10 levels were normalized using natural log transformation for statistical analysis. Statistical analysis included chi 2, Fisher exact test, and analysis of variance, with P < .05 considered significant. RESULTS. From the AF data base, 18 patients (6%) delivered SGA neonates and were matched with 46 controls. From the maternal serum data base, 13 patients (7%) delivered SGA neonates and were matched with 45 controls. Neither AF nor maternal serum interleukin-10 levels were significantly different in patients subsequently delivering SGA neonates compared with controls (AF: median 21.0 pg/mL. [range 13.8-27.6] versus 17.5 pg/mL. [range 8.9-362.12], P = .18; serum: median 15.7 pg/mL [range 9.9-73.5] versus 18.7 pg/mL [range 9.7-71.7], P = .60, respectively). No significant differences were identified in gestational age at sampling, maternal smoking history, pregnancy-induced hypertension, or elevated MSAFP in patients delivering SGA neonates compared with controls (P > .05 for each). As expected, birth weight was significantly lower in patients delivering SGA neonates compared with controls (P < .001).

CONCLUSION

Second-trimester AF or maternal serum interleukin-10 levels are not predictive of subsequent delivery of SGA infants.

摘要

目的

评估孕中期早期羊水(AF)或母血清中的白细胞介素-10水平在控制分娩孕周后能否作为小于胎龄(SGA)儿后续发生情况的预测指标。

方法

我们确定了1992年1月至1995年2月期间因标准遗传指征接受遗传羊膜腔穿刺术或因母血清甲胎蛋白(MSAFP)/三联筛查进行母血采样且有可用分娩随访数据的患者。小于胎龄定义为出生体重低于相应孕周的第十百分位数。对照患者在分娩孕周、母亲年龄、种族和产次方面与每位研究患者至少匹配两名对照。我们排除了患有母体免疫疾病、慢性高血压、糖尿病、哮喘、先天性心脏病、多胎妊娠以及有结构或染色体异常的胎儿。对孕中期羊水和血清样本进行白细胞介素-10检测。考虑的潜在混杂变量有MSAFP水平、吸烟史、妊娠高血压和新生儿性别。白细胞介素-10水平采用自然对数转换进行标准化以进行统计分析。统计分析包括卡方检验、Fisher精确检验和方差分析,P < 0.05被认为具有统计学意义。结果。从羊水数据库中,18例患者(6%)分娩出SGA新生儿,并与46例对照匹配。从母血清数据库中,13例患者(7%)分娩出SGA新生儿,并与45例对照匹配。与对照相比,后续分娩出SGA新生儿的患者羊水和母血清白细胞介素-10水平均无显著差异(羊水:中位数21.0 pg/mL[范围13.8 - 27.6]对17.5 pg/mL[范围8.9 - 362.12],P = 0.18;血清:中位数15.7 pg/mL[范围9.9 - 73.5]对18.7 pg/mL[范围9.7 - 71.7],P = 0.60)。与对照相比,分娩出SGA新生儿的患者在采样时的孕周、母亲吸烟史、妊娠高血压或MSAFP升高方面均未发现显著差异(每项P > 0.05)。正如预期的那样,与对照相比,分娩出SGA新生儿的患者出生体重显著更低(P < 0.001)。

结论

孕中期羊水或母血清白细胞介素-10水平不能预测SGA儿的后续分娩情况。

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