孕早、中期唐氏筛查血清标志物与新生儿出生体重的相关性研究  

Correlation between the serum markers in Down’s screenings and neonatal birth weight at early and mid pregnancy

作　　者：米冬青[1] 宋歌[1] 米梅艳[1] 张晶 孙东兰[1] 张静[1] MI Dongqing;SONG Ge;MI Meiyan(The Fourth Hospital of Shijiazhuang City,Hebei, Shijiazhuang 050011,China)

机构地区：[1]河北省石家庄市第四医院,050011

出　　处：《河北医药》2020年第10期1515-1518,共4页Hebei Medical Journal

基　　金：河北省医学科学研究重点课题(编号:20150890)。

摘　　要：目的探研孕早期和孕中期唐氏筛查的血清标志物与新生儿体重的相关性。方法以2016年1月至2018年12月进行产检且分娩足月单活胎新生儿的孕妇为研究对象,从其中选取166例分娩低出生体重新生儿的孕妇(低出生体重组)和1247例分娩正常体重新生儿的孕妇(正常体重儿组)的产检资料进行回顾性分析,比较2组孕妇早孕期血清中人绒毛膜促性腺激素(Free hCGβ)、妊娠相关蛋白A(PAPP-A)和中孕期血清中甲胎蛋白(AFP)、血清中Free hCGβ、游离雌三醇(uE3)水平的差异,Logistic多因素分析血清标志物与新生儿体重的相关性,采用受试者工作特征曲线(ROC)分析血清标志物对低出生体重儿的预测价值。结果在低出生体重组和正常体重儿组中,孕妇分娩方式的差异有统计学意义(P<0.05)。低出生体重组中,孕中期uE3 MoM值和孕早期PAPP-A MoM值低于正常体重儿组,差异有统计学意义(P<0.05)。Logistic多因素分析结果显示,孕中期uE3 MoM值与低出生体重的发生呈负相关,其相关系数和OR值分别为-4.406和0.012;孕早期PAPP-A MoM值与低出生体重的发生呈负相关,其相关系数和OR值分别为-0.43和0.651.4、ROC曲线分析结果显示,孕中期uE3 MoM值和孕早期PAPP-A MoM值预测低出生体重发生的ROC面积分别为0.772和0.603。结论孕妇孕中期uE3和孕早期PAPP-A水平是影响新生儿体重的因素,较低的孕中期uE3水平和孕早期PAPP-A水平的孕妇分娩低出生体重儿的概率较大,孕妇孕中期uE3 MoM值和孕早期PAPP-A MoM值对低出生体重的发生有一定的预测价值。Objective To investigate the correlation between the serum markers in Down’s screenings and neonatal birth weight at early and mid pregnancy.Methods The pregnant women who had the prenatal examination and the delivery in our hospital from January 2016 to December 2018 were enrolled as research objects.The clinical data of 166 pregnant women with the low birth weight neonates(low birth weight group)and 1,247 pregnant women with the normal birth weight neonates(normal birth weight group)were retrospectively analyzed.The serum levels of human chorionic gonadotropin(Free hCGβ),the pregnancy-associated plasma protein A(PAPP A),serum alpha fetoprotein in second trimester(AFP),unconjugated estriol(uE3)were observed and compared between the two groups.The correlation between the serum marker and the neonatal weight was analyzed by means of Logistic multiple-factor analysis,moreover,the receive operating characteristic curve(ROC)was employed to analyze the predictive value of the serum markers in prediction of low birth weight.Results There was significant difference in the delivery mode between low birth weight group and normal birth weight group(P<0.05).Moreover the uE3 MoM at pregnant metaphase and PAPP A MoM at early pregnancy in low birth weight group were significantly lower than those in normal birth weight group(P<0.05).The logistic multiple-factor analysis results showed that the uE3 MoM at pregnant metaphase was negatively correlated with low birth weight neonates,and the correlation coefficient and OR value were-4.406 and 0.012,respectively.Moreover the PAPP A MoM value at early pregnancy was negatively correlated with low birth weight neonates,and the correlation coefficient and OR value were-0.43 and 0.651.4,respectively.The ROC curve analysis results indicated that the ROC area which predicted the occurrence of low birth weight neonates by the uE3 MoM at pregnant metaphase and the PAPP A MOM value at early pregnancy were 0.772 and 0.603,respectively.Conclusion The levels of uE3 of pregnant women at pregna

关 键 词：新生儿出生体重 妊娠相关蛋白A 游离雌三醇 甲胎蛋白 人绒毛膜促性腺激素 

分 类 号：R725.961[医药卫生—儿科]