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抗凝药的使用与较低的胎儿分数和更不确定的结果有关

Raj Shree¹, Hayley J MacKinnon¹, Joely Hannan²

¹Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Washington, Seattle, WA.

American journal of obstetrics and gynecology

|July 10, 2023

概括

母亲使用抗凝血剂,而不是阿司匹林,通过降低胎儿分数,显著增加了无细胞DNA查的不确定的结果. 这表明是稀释效应,而不是实验室变化,影响查准确性.

科学领域:

产科和妇科产科和妇科
遗传学是一个遗传学.
分子生物学分子生物学

背景情况:

孕产妇使用抗凝剂可能会增加无细胞DNA (cfDNA) 查的不确定的结果.
之前的研究被自身免疫性疾病所混,这也提高了不确定的结果.
在cfDNA查中Z分数变化的病因不明.

研究的目的:

评估孕妇抗凝血剂对抗对照剂的cfDNA查性能,不包括自身免疫性疾病.
为了评估胎儿分数,不确定结果率和cfDNA度的差异.
检查实验室测试特征,包括碎片大小,GC含量和Z分数.

主要方法:

对1707名接受cfDNA查的孕妇进行回顾性研究 (2017-2021年).
排除了自身免疫性疾病,疑似形形状,以及缺失的胎儿分数数据.
对抗凝血和阿司匹林组与对照组进行比较,多变量分析控制BMI,妊娠年龄和胎儿性别.

主要成果:

抗凝剂与明显较低的胎儿分数 (9.3%与11.7%相比),较高的不确定率 (17.2%与2.7%相比) 和较高的cfDNA度 (218与83.7ppg/μL相比) 相关.
阿司匹林使用显示出较低胎儿分数的趋势,但在未确定率或cfDNA度上没有显著差异.
抗凝固药物增加了不确定结果的几率>8倍 (aOR 8.7),独立于实验室指标,如碎片大小或GC含量.

结论:

独立于自身免疫性疾病的孕产妇抗凝药与胎儿分数的降低和cfDNA查中不确定的结果的增加有关.
阿司匹林的使用没有显著影响不确定的结果率.
结果表明抗凝剂对cfDNA的稀释作用,影响查准确性而不是实验室测定性能.

关键词:

在Z-分数中,Z-分数是值得的.这是一种抗凝血药物.阿司匹林是一种阿司匹林.没有细胞的DNA DNA.胎儿分数胎儿分数不确定结果的不确定结果.非侵入性的产前查.

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