在怀疑早产子的妇女中重复胎盘生长因子测试 (PARROT-2):多中心,并行组,优越性,随机对照试验
Alice Hurrell1, Louise Webster1, Jenie Sparkes1
1Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK.
Lancet (London, England)
|February 11, 2024
概括
重复的胎盘生长因子 (PlGF) 测试没有改善怀疑早产子的围产期结局. 在低不良事件率的高收入环境中不建议进行例行重复PlGF测试.
科学领域:
- 产科和妇科
- 产妇和胎儿医学
- 临床诊断
背景情况:
- 基于胎盘生长因子 (PlGF) 的测试准确地预测出产前.
- 在怀疑早产子时重复进行PlGF测试的临床益处尚不清楚.
- 这项研究调查了重复的PLGF测试是否改善了围产期的结果.
研究的目的:
- 确定基于胎盘生长因子 (PlGF) 的重复测试是否会减少怀孕期间怀孕的怀孕女性的不良结果.
- 使用国家推的PlGF值来评估管理算法的临床效用.
- 评估暴露与隐藏的重复PlGF测试对孕产妇和产周健康的影响.
主要方法:
- 一个多中心,并行组,优越性随机对照试验,涉及1253名怀孕妇女怀疑先兆子.
- 女性被随机分配到暴露的重复PlGF测试或隐藏的重复测试.
- 主要结局是死产,新生儿早期死亡或新生儿病房入院的综合结果.
主要成果:
- 在公开 (31.2%) 和隐蔽 (27.8%) 重复PlGF测试组之间,在初级周产综合结果中没有发现显著差异 (RR 1. 21;95% CI 0. 95-1.33; p=0. 18).
- 每项方案分析得出了类似的结果,表明重复测试没有益处.
- 严重的不良反应很少发生,并且在两组中都被认为与干预无关.
结论:
- 在怀疑患有妊娠前的孕妇中,对基于PlGF的重复测试没有改善产周结局.
- 在高收入环境中,不建议对所有怀疑患有先兆子的个体进行基于PLGF的普遍,常规的重复测试.
- 目前PlGF测试的诊断准确性支持其用于初始预测,但重复测试没有额外的产周益处.
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