40398例孕中期孕妇唐氏综合征血清学筛查报告分析  

Analysis of 40398 cases of serological screening report for Down's syndrome in second trimester pregnant women

作　　者：李金玲 张杰 游园园 李妍 Li Jinling;Zhang Jie;You Yuanyuan;Li Yan(Department of Genetics,Shenyang Maternity and Child Health Care Hospital,Shenyang 110000,China)

机构地区：[1]沈阳市妇幼保健院遗传科,沈阳110000

出　　处：《保健医学研究与实践》2023年第11期73-77,共5页Health Medicine Research and Practice

基　　金：辽宁省沈阳市卫健委科研项目(2022085)。

摘　　要：目的本研究通过对沈阳市及其周边地区2019—2021年共计40398例孕中期孕妇唐氏综合征(DS)血清学筛查结果进行分析,以及与2012—2014年进行DS产前筛查孕妇的基本情况进行比较,探讨孕妇年龄、孕周等相关因素与DS高风险检出率的关系,为优化筛查策略,提高筛查效率提供理论基础。方法选取2019年11月—2021年5月于沈阳市妇幼保健院进行产前筛查的孕妇40398例作为研究对象,进行血清甲胎蛋白(AFP)、人绒毛膜促性腺激素游离β亚基(free β-hCG)、游离雌三醇(uE3)的检测,评估DS、18-三体综合征(ES)及开放性神经管缺陷(ONTD)的发生风险,分析孕周与预产年龄对高风险检出率的影响。同时,回顾并与2012年1月—2014年12月沈阳市妇幼保健院122320例孕妇的中期DS筛查结果进行比较。结果与2012—2014年进行产前筛查的孕妇相比,2019—2021年进行产前筛查的孕妇预产年龄由(27.52±3.92)岁增长到(28.39±3.86)岁;体质量由(61.17±10.37)kg增长到(63.67±11.67)kg;吸烟率有所升高(P<0.05);DS、ES及ONTD高风险检出率差异不具有统计学意义(P>0.05)。2019—2021年进行产前筛查的孕妇中,其血清AFP和uE3水平随孕周的增加而升高,free β-hCG水平随孕周增加而下降;不同孕周孕妇的DS和ES高风险检出率差异均有统计学意义(P<0.05);不同预产年龄孕妇DS、ES高风险检出率的差异均有统计学意义(P<0.05),其DS、ES高风险检出率随着预产年龄增长呈现升高的趋势;辅助生殖孕妇的DS、ES及ONTD高风险检出率高于自然受孕者,差异有统计学意义(P<0.05)。结论DS、ES及ONTD的高风险检出率受孕周、年龄和受孕方式的影响。且血清学筛查对于辅助生殖的孕妇还存在假阳性风险高的问题,因此对于该人群应制定更合理的筛查策略,从而提高检测效率,减少不必要的经济支出,减轻孕妇心理负担。Objective This paper aims to investigate the relationship between maternal age,gestational age,and other related factors and the high-risk detection rate of Down's syndrome(DS)by analyzing the serological screening results for DS in 40398 pregnant women in the second trimester from 2019 to 2021 in Shenyang and its surrounding areas and comparing them with the pregnant women who underwent DS prenatal screening from 2012 to 2014 to provide evidence for optimizing screening strategies and potentiating screening efficiency.Methods Overall,40398 pregnant women who underwent prenatal screening in Shenyang Maternity and Child Health Care Hospital from November 2019 to May 2021 were selected as the study participants.Serum alpha-fetoprotein(AFP),free β-hCG,and free estriol(uE3)were measured to assess the risk of DS,18 trisomy syndrome(ES),and open neural tube defects(ONTDs).Besides,the effects of gestational age and age at delivery on the high-risk detection rate were analyzed.Meanwhile,the mid-term DS screening results of 122320 pregnant women in our hospital from January 2012 to December 2014 were reviewed and compared.Results Compared with pregnant women who underwent prenatal screening from 2012 to 2014,the age of predelivery of pregnant women who underwent prenatal screening from 2019 to 2021 increased from(27.52±3.92)years to(28.39±3.86)years;body mass increased from(61.17±10.37)kg to(63.67±11.67)kg;the smoking rate increased,with statistical significance(P<0.05).No significant difference was observed in the detection rate of DS,ES,and ONTD high-risk(P>0.05).Among pregnant women who underwent prenatal screening from 2019 to 2021,their serum AFP and uE3 levels increased with gestational age,and freeβ-HCG levels decreased with gestational age.Significant differences were observed in the detection rates of high risk of DS and ES between pregnant women at different gestational weeks(P<0.05).Significant differences were found in the detection rates of high risk of DS and ES between pregnant women at different pren

关 键 词：21-三体综合征 18-三体综合征 开放性神经管缺陷 产前筛查 

分 类 号：R714.55[医药卫生—妇产科学]