评估孕产妇第一季度母体血清中因希宾-A,以查孕前
Sakita Moungmaithong1, Angel H Kwan2, Ada W Tse2
1Department of Obstetrics and Gynaecology, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
PloS one
|July 10, 2023
概括
孕产妇血清抑制剂-A没有改善早产前查. 在FMF三重试验中,在FMF三重试验中添加或替换胎盘生长因子以inhibin-A并没有提高早产前的检测率.
科学领域:
- 孕产妇和胎儿的医学
- 发现生物标志物的发现.
- 孕前的查 孕前的查
背景情况:
- 国际指导方针建议在高风险的早产前 (PE) 时服用阿司匹林,在头三个月内发现.
- 胎儿医学基金会 (FMF) 对早产儿期的查测试显示,亚洲人群中检测率较低.
- 需要额外的生物标志物来改善PE查,特别是在不同的种族群体中.
研究的目的:
- 为了评估怀孕11-13周的母体血清抑制剂-A作为潜在的替代品或补充胎盘生长因子 (PlGF) 在早产PE的FMF查测试中.
- 评估inhibin-A在改善混合风险人群中早产PE检测率方面的实用性.
主要方法:
- 一项嵌套病例对照研究,涉及1,792个单独怀孕,在11-13周进行查.
- 在112例PE病例和1,680例对照中追溯测量了母亲血清中的胺-A水平.
- 分析选性能使用接收器运行特征曲线 (AUC) 和检测率 (DR) 在10%的假阳性率 (FPR),比较inhibin-A与plGF在FMF三重测试模型内.
主要成果:
- 与未受影响的怀孕相比,在任何发病,早产和长期PE的怀孕中,平均inhibin-A水平显著更高.
- 在FMF三重试验中用PlGF替换inhibin-A,AUC从0.859降至0.837,DR从64.86%降至54.05%.
- 在FMF三重试验中添加inhibin-A导致AUC在统计学上显著降低 (p=0.001),并错过了10.8%的早产期PE病例.
结论:
- 孕产妇血清抑制剂-A在使用作为PLGF的替代品或补充剂时,不会改善早产PE的FMF三重检测的查性能.
- 将抑制素-A纳入当前的FMF查协议可能会导致检测怀孕的数量减少,否则会被识别出来.
- 需要进一步的研究,以确定有效的生物标志物来改善早产期PE查,特别是在未被确定的人群中.
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