阴道分泌物胎儿纤维连接蛋白水平和宫颈长度对先兆早产孕妇发生自发性早产的预测价值及先兆早产孕妇发生自发性早产的危险因素  

Predictive value of fetal fibronectin in vaginal secretions and cervical length for spontaneous preterm birth in pregnant women with threatened preterm labor and risk factors for developing spontaneous preterm birth in pregnant women with threatened preterm labor

作　　者：孔琳[1] 潘平山[1] 谭芸[1] 林莲恩[1] KONG Lin;PAN Ping-shan;TAN Yun;LIN Lian-en(Department of Obstetrics,the Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region,Nanning 530003,China)

机构地区：[1]广西壮族自治区妇幼保健院产科,南宁市530003

出　　处：《广西医学》2020年第15期1935-1938,1958,共5页Guangxi Medical Journal

基　　金：广西医药卫生科研课题(Z2012203,Z2012199)。

摘　　要：目的探讨阴道分泌物胎儿纤维连接蛋白(fFN)和宫颈长度对先兆早产孕妇发生自发性早产的预测价值,以及影响先兆早产孕妇发生自发性早产的危险因素。方法选择160例先兆早产孕妇(单、双胎各80例),检测其发生先兆早产时阴道分泌物fFN水平与宫颈长度。评价阴道分泌物fFN水平和宫颈长度单独或联合预测先兆早产孕妇发生自发性早产的价值,并分析先兆早产孕妇发生自发性早产的危险因素。结果最终共89例孕妇发生自发性早产。在单胎或双胎妊娠孕妇中,阴道分泌物fFN水平、宫颈长度以及阴道分泌物fFN水平联合宫颈长度预测自发性早产的敏感度、特异度、准确度均高于70%,且两者联合时以上指标均高于单一指标(均P<0.05)。羊水过多、妊娠期糖尿病、子痫前期、胎儿宫内窘迫是先兆早产孕妇发生自发性早产的独立危险因素(均P<0.05)。结论阴道分泌物fFN水平和宫颈长度对先兆早产孕妇发生自发性早产均有一定的预测价值,两者联合应用可显著提高预测效能。对于先兆早产的孕妇,出现羊水过多、妊娠期糖尿病、子痫前期、胎儿宫内窘迫时自发性早产的风险增加。Objective To explore the predictive value of fetal fibronectin(fFN)and cervical length for spontaneous preterm birth in pregnant women with threatened preterm labor,as well as the risk factors affecting the incidence of spontaneous preterm birth in pregnant women with threatened preterm labor.Methods A total of 160 pregnant women with threatened preterm labor were enrolled,including 80 singletons and 80 twins,to detect their vaginal secretions fFN level and cervical length when threatened preterm labor occurred.The predictive value of vaginal secretions fFN level and cervical length alone or in combination for developing spontaneous preterm birth in pregnant women with threatened preterm labor was assessed,and the risk factors for developing spontaneous preterm birth in pregnant women with threatened preterm labor were analyzed.Results A total of 89 pregnant women had spontaneous premature birth eventually.In pregnant women with singleton or twin pregnancy,vaginal secretions fFN level,cervical length and their combination all had sensitivity,specificity and accuracy higher than 70% for predicting spontaneous premature birth,and their combination exhibited higher indicators mentioned above than either of the indices(all P<0.05).Polyhydramnios,gestational diabetes mellitus,preeclampsia,and fetal intrauterine distress were the independent risk factors for developing spontaneous preterm birth in pregnant women with threatened preterm labor(all P<0.05).Conclusion Vaginal secretions fFN level and cervical length have a certain predictive value for spontaneous preterm birth in pregnant women with threatened preterm labor,and their combination use can improve predictive efficiency remarkably.Pregnant women with threatened preterm labor might be at increased risk for spontaneous preterm birth when suffering from polyhydramnios,gestational diabetes mellitus,preeclampsia,or fetal intrauterine distress.

关 键 词：自发性早产 先兆早产 胎儿纤维连接蛋白 阴道分泌物 宫颈长度 预测价值 危险因素 

分 类 号：R714.21[医药卫生—妇产科学]