双胎妊娠孕11～13+6w唐氏筛查血清标志物及miR-200C水平与分娩结局的关系探讨  

Relationship between serum markers and miR-200C levels in 11～13+6 weeks of pregnancy on outcome of twin pregnancy

作　　者：林韶华 李文香 王靖 卢广艺 LIN Shao-hua;LI Wen-xiang;WANG Jing;LU Guang-yi(Department of Reproductive,GuangxiInternational Zhuang Medical Hospital,Nanning,Guangxi 532021,China;Department of Gynecology,Nanning Womenand Children Health Care Hospital,Nanning 530012,China)

机构地区：[1]广西国际壮医医院生殖科,南宁532021 [2]南宁市妇幼保健院妇科,南宁530012

出　　处：《中国优生与遗传杂志》2019年第5期571-574,共4页Chinese Journal of Birth Health & Heredity

摘　　要：目的探讨双胎妊娠孕11~13^+6w唐氏筛查血清标志物及miR-200C水平与分娩结局的关系。方法选取2016年2月-2017年2月医院接收的孕11~13^+6w双胎妊娠孕妇120例。收集孕妇空腹血清,检测唐氏筛查血清标志物:妊娠期相关蛋白-A(PAPP-A)、人绒毛膜促性腺激素(β-hCG),并检测血清微小RNA(miR)-200C水平。根据随访结果,将发生不良妊娠结局孕妇纳入不良组,其余纳入良正常组,根据胎儿妊娠结局将孕妇分为单胎不良组、双胎不良组及正常组。对比母体及胎儿各组血清PAPP-A、β-hCG、miR-200C相对表达量;采用多因素Logistic回归分析法明确影响母体及胎儿不良妊娠结局的危险因素。结果共55例出现孕妇不良分娩结局,不良组孕妇血清PAPP-A与正常组比较显著较低(P<0.05),血清β-hCG及miR-200C相对表达量与正常组比较显著较高(P<0.05);单胎不良分娩结局15例、双胎不良分娩结局8例,单胎及双胎不良组孕妇血清PAPP-A均显著低于正常组(P<0.05),双胎不良组孕妇血清PAPP-A显著低于单胎不良组(P<0.05),单胎及双胎不良组孕妇血清β-hCG及miR-200C相对表达量均显著高于正常组(P<0.05),双胎不良组孕妇血清PAPP-A显著高于单胎不良组(P<0.05);经Logistic回归分析,PAPP-A<2988.50mU/L、β-hCG>62.35ng/mL、miR-200C相对表达量>0.25均是导致母体不良妊娠结局、单胎及双胎不良分娩结局的危险因素(P<0.05)。结论双胎妊娠孕11~13^+6w孕妇血清PAPP-A降低、β-hCG及miR-200C表达升高是母体、单胎及双胎不良分娩结局的危险因素,与双胎妊娠分娩结局关系密切。Objective:To investigate the relationship between serum markers and miR-200C levels and the outcome of delivery in 11~13^+6weeks pregnancy of twin pregnancy.Methods:120 pregnant women with twin pregnancy from 11~13^+6weeks of pregnancy were enrolled in the hospital from February 2016 to February 2017.Pregnant women′s fasting serum was collected and Down′s screening serum markers were detected:pregnancy-associated protein-A(PAPP-A),human chorionic gonadotropin(β-hCG),and serum microRNA(miR)-200C levels were measured.According to the follow-up results,pregnant women with adverse pregnancy outcomes were included in the adverse group,and the rest were included in the normal group.The pregnant women were divided into single-fetal group,twin-bad group and normal group according to the fetal pregnancy outcome.The relative expressions of serum PAPP-A,β-hCG and miR-200C in maternal and fetal groups were compared.Multivariate logistic regression analysis was used to identify risk factors affecting maternal and fetal adverse pregnancy outcomes.Results:A total of 55 cases of poor delivery outcomes in pregnant women.Serum PAPP-A in the adverse group was significantly lower than that in the normal group(P<0.05),and the serumβ-hCG and relative expression of serum miR-200C were significantly higher than those in the normal group(P<0.05).There were 15 cases of single birth failure and 8 cases of bad birth outcome.Serum PAPP-A was significantly lower in the single-fetal group and twin-bad group than those in the normal group(P<0.05),while the serum PAPP-A in the twin-bad group was significantly lower than that in the single-fetal group(P<0.05).Serumβ-hCG and relative expression of serum miR-200C were significantly higher in the single-fetal group and twin-bad group than those in the normal group(P<0.05),while the serumβ-hCG and relative expression of serum miR-200C in the twin-bad group were significantly higher than that in the single-fetal group(P<0.05).Logistic regression analysis showed that PAPP-A<2988.50 mU/L,β-hCG

关 键 词：孕11~13^+6w 妊娠期相关蛋白-A 人绒毛膜促性腺激素 微小RNA-200C 双胎妊娠 分娩结局 

分 类 号：R714.2[医药卫生—妇产科学]