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竞争风险模型与血管性因素在怀孕中期查中与早产生长相关的新生儿发病率的比较
I Papastefanou1, M Menenez2, A Szczepkowska2
1Department of Women and Children's Health, School of Life Course and Population Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK.
概括
在预测早产生长相关的新生儿发病率方面,对于小至孕期年龄 (SGA) 的竞争风险模型显著优于高可溶性fms-like氨酸激酶-1 (sFlt-1) /胎盘生长因子 (PlGF) 比率或低的PlGF.
科学领域:
- 孕产妇和胎儿的医学
- 新生儿结局的结果.
- 生物标志物研究的研究.
背景情况:
- 预测与早产生长相关的新生儿发病率对于及时干预至关重要.
- 目前使用可溶性fms类铁酸酶-1 (sFlt-1) /胎盘生长因子 (PlGF) 比率或低PlGF的选方法存在局限性.
研究的目的:
- 评估高sFlt-1/PlGF比率或低PlGF对于与早产生长相关的新生儿发病率的预测性能.
- 将这些标记物的预测性能与SGA的竞争风险模型进行比较.
主要方法:
- 对40241名怀孕19至24周的妇女进行前性观察性研究.
- 收集的母体数据,超声波参数 (估计胎儿体重,子宫动脉脉动指数) 和血清sFlt-1/PlGF水平.
- 对SGA (<第10或第3百分位) 的评估预测率与新生儿单位入院或重大发病率.
主要成果:
- 与高sFlt-1/PlGF比率或低PlGF相比,竞争风险模型显示SGA和相关发病率的预测优越.
- 在10%的选阳性率下,竞争风险模型实现了SGA与新生儿不良后果的70-78%的检测率.
- 这些比率明显高于通过sFlt-1/PlGF比率或低PlGF查实现的35-40%的检测率.
结论:
- 竞争风险模型是一个更有效的工具,用于预测产前期生长相关的新生儿发病率.
- 这个模型整合了孕产妇因素,超声波和生物标志物,以提高预测准确度.
- 研究结果表明,在产科护理中,人们正在转向更全面的预测模型.
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