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孕产妇第一季度的alpha-fetoprotein和胎盘介导的妊娠并发症

Nir Melamed¹, Nanette Okun¹, Tianhua Huang^2,3

¹Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre (N.M., N.O., A.A.), University of Toronto, Toronto, Ontario, Canada.

Hypertension (Dallas, Tex. : 1979)

|September 6, 2023

概括

第一个三个月升高的α-fetoprotein (AFP) 不是胎盘介导并发症的独立预测因素,与第二个三个月的AFP不同. 这一发现对于理解提高第一季度查准确度至关重要.

科学领域:

孕产妇与胎儿的医学
在产前查.
生物化学生物化学

背景情况:

对于21型三体症查的母体血清标志物与胎盘介导的并发症有关.
增强的第一季度查 (FTS) 现在包括α-fetoprotein (AFP) 和胎盘生长因子 (PlGF).
第一季度AFP与胎盘介导并发症之间的关联尚未得到充分证实.

研究的目的:

评估第一季度AFP与胎盘介导并发症的相关性.
为了将这种关联与第二季度AFP和其他第一季度标志物进行比较.
为了确定第一季度的AFP是否是一个独立的风险因素.

主要方法:

在加拿大安大略省 (2013-2019) 接受21型三症候群查的妇女的回顾性队列研究.
评估了第一季度AFP与死产或早产胎盘并发症的复合结果的关联.
与PAPP-A,β-hCG,PlGF和第二个三个月的AFP进行比较.

主要成果:

所有测试的标志物都与主要结局存在关联.
与低PAPP-A,低PlGF和高第二季度AFP相比,第一季度AFP升高的关联较弱 (aRR,1.57).
在对所有增强的FTS标记进行调整后,第一季度AFP升高不再与结果相关 (aRR,0.77).

结论:

第一个三个月升高的AFP不是胎盘介导并发症的独立风险因素.
第一季度AFP的预测值与第二季度AFP的预测值有很大的不同.
这些发现支持对增强的FTS标记的解释进行细化.

关键词:

阿尔法-胎儿蛋白质是一种阿尔法-胎儿蛋白质.胎盘胎盘胎盘胎盘孕产妇产前炎症 (pre-eclampsia) 是一个严重的疾病.怀孕怀孕怀孕怀孕怀孕女人女人女人女人女人

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