第一个三个月的胎盘和产前死产的风险
Gordon C S Smith1, Jennifer A Crossley, David A Aitken
1Department of Obstetrics and Gynaecology, Cambridge University and Rosie Hospital, Cambridge, England. gcss2@cam.ac.uk
JAMA
|November 13, 2004
概括
怀孕早期的胎盘功能,以低妊娠相关血蛋白A (PAPP-A) 水平来表示,显著增加死产风险. 这一发现表明,在怀孕前10周内可以确定死产风险.
科学领域:
- 产科和妇科 产科和妇科
- 围产儿医学 围产儿医学
- 生殖生物学 生殖生物学
背景情况:
- 早产和低出生体重与第一季度的发育有关.
- 在头三个月内确定死产风险仍然不清楚.
研究的目的:
- 调查第一季度的胎盘功能标志物与产前死产风险之间的关联.
- 为了确定在怀孕早期循环的胎盘功能标志物是否预测死产.
主要方法:
- 这是一项前性,多中心的队列研究,涉及苏格兰7934名女性 (1998-2000年).
- 血液样本是在怀孕前10周内采集的.
- 分析包括在怀孕24周或之后的单独分娩,与国家出生和死亡登记处联系在一起.
主要成果:
- 在第一季度低水平的妊娠相关血蛋白A (PAPP-A) 与显著更高的死产风险相关 (HR,9.2;P<.001).
- 这种关联在胎盘功能障碍导致的死胎中尤为强烈 (HR, 46.0; P<.001).
- 没有发现PAPP-A水平与其他死产原因或母亲因素之间的关联.
结论:
- 通过PAPP-A水平评估的头三个月的胎盘功能可能决定了怀孕后期死产的风险.
- 早期怀孕标志物可以提供关于预测和潜在地预防死产的见解.
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