第一个季度的PLGF和PAPP-A以及胎盘介导并发症的风险:预测前性研究
Marie-Laurence Côté1, Yves Giguère2, Jean-Claude Forest2
1Reproduction, Mother and Child Health Unit, CHU De Québec-Université Laval Research Center, Université Laval, Québec City, Québec, Canada.
Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC
|December 4, 2024
概括
第一个三个月内胎盘生长因子 (PlGF) 和与怀孕相关的血蛋白A (PAPP-A) 的低水平表明37周前怀孕不良结果的风险很高. 孤立的低PAPP-A不是一个显著的风险因素.
科学领域:
- 孕产妇和胎儿的医学
- 生殖内分泌学 生殖内分泌学
- 生物标志物研究的研究.
背景情况:
- 第一个三个月的查对于识别妊娠并发症至关重要.
- 胎盘生长因子 (PlGF) 和与怀孕相关的血蛋白A (PAPP-A) 是关键的生物标志物.
- 了解综合生物标志物影响可以提高风险预测.
研究的目的:
- 评估第一季度低PLGF和PAPP-A水平与胎盘介导并发症之间的关联.
- 为了确定低PLGF和PAPP-A组合的不良妊娠结果的预测值.
- 为了澄清与孤立的低PAPP-A相关的风险.
主要方法:
- 预测研究数据的二次分析.
- 在11~14周怀孕时包括无双的参与者.
- 根据低 (<0.4 MoM) PlGF和PAPP-A水平分为四个组的分层.
- 综合不良结果定义包括先孕,胎儿生长限制,胎儿死亡和胎盘断裂在34周,37周和≥37周之前.
主要成果:
- 低PAPP-A和低PlGF的组合显示,在37周 (21%) 和34周 (12%),对不良结果的风险最高.
- 与组合低标志物相比,单独的低PLGF在37周前有7%的风险,单独的低PAPP-A有2%的风险.
- 对于早产前,联合低标志物呈现12%的风险,明显高于单独标志物.
结论:
- 联合较低的第一季度PLGF和PAPP-A水平与37周和34周之前出现不良妊娠结果的非常高风险密切相关.
- 单独的低PAPP-A水平不应被认为是妊娠不良结果的危险因素.
- 这一发现支持使用PlGF和PAPP-A联合查来更好地预测妊娠并发症.
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