早孕期母血清PAPP-A水平与不良妊娠结局的相关性分析  

Correlation between maternal serum PAPP-A level in early pregnancy and adverse pregnancy outcomes

作　　者：张颖[1] 段红蕾[1] 李洁[1] ZHANG Ying;DUAN Honglei;LI Jie(Prenatal Diagnosis Center,Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School,Nanjing,Jiangsu 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院产前诊断中心,江苏南京210008

出　　处：《中国优生与遗传杂志》2022年第11期1972-1975,共4页Chinese Journal of Birth Health & Heredity

摘　　要：目的探讨早孕期母血清妊娠相关蛋白-A(PAPP-A)对不良妊娠结局的预测价值。方法选择2017年1月至2019年8月在南京大学医学院附属鼓楼医院产前诊断中心进行NT检查并接受早孕期唐氏综合征筛查的孕妇,随访其妊娠结局分析其血清中PAPP-A的浓度(MoM值)和小于胎龄儿(SGA)相关关系,并评估PAPP-A的浓度(MoM值)对不良妊娠结局的预测价值。结果纳入分析的3029例孕妇中,SGA组PAPP-A标志物浓度(MoM值)(0.87±0.500)明显小于非SGA组(1.05±0.555),早孕期母血清中PAPP-A标志物浓度(MoM值)与SGA呈正相关(P<0.01)。PAPP-A标志物水平预测SGA、早产型PE、足月产型PE及总体不良结局的ROC曲线下面积分别为0.60、0.63、0.59、0.61,预测价值有限。结论早孕期母血清中PAPP-A标志物浓度(MoM值)水平较低对于不良妊娠结局的发生有一定的预测作用;以0.59为截断值,预测SGA、早产型PE、足月产型PE及总体不良结局特异性好于敏感性。Objective To investigate the predictive value of pregnancy-associated plasma protein A(PAPP-A)in early pregnancy for adverse pregnancy outcomes.Methods From January 2017 to August 2019,pregnant women who underwent NT examination and Down syndrome screening in the prepartum diagnosis center of Nanjing Drum Tower Hospital were enrolled and their pregnancy outcomes were followed up.Analyze the relationship between serum PAPP-A concentration(MoM)and small gestational age(SGA).The predictive value of PAPP-A concentration(MoM value)for adverse pregnancy outcomes was evaluated by subject operating characteristic curves.Results Among 3029 pregnant women included in the analysis,the concentration of PAPP-A marker(MoM)in SGA group(0.87±0.500)was significantly lower than that in non-SGA group(1.05±0.555).There was a positive correlation between the concentration of PAPP-A marker(MoM)in early pregnancy and SGA(P<0.01).The areas under ROC curve for PAPP-A marker level to predict SGA,preterm PE,term PE and overall adverse outcomes were 0.60,0.63,0.59 and 0.61,respectively,showing limited predictive value.Conclusion Low serum PAPP-A marker concentration(MoM value)in early pregnancy can predict the occurrence of adverse pregnancy outcomes.The specificity was better than sensitivity in predicting SGA,preterm PE,term PE and overall adverse outcomes with 0.59 as the cut-off value.

关 键 词：妊娠相关蛋白-A 小于胎龄儿 子痫前期 

分 类 号：R714.5[医药卫生—妇产科学]