高龄孕妇雄激素水平与不良妊娠结局的关系  

Relationship between androgen level and adverse pregnancy outcome of pregnant women at advanced maternal age

作　　者：陈文仪 吴学磊 卢凤英 张铭[2] 张玢 虞斌 CHEN Wenyi;WU Xuelei;LU Fengying;ZHANG Ming;ZHANG Bin;YU Bin(Department of Medical Genetics,Changzhou Maternal and Child Health Care Hospital,Changzhou,Jiangsu 213000,China;Changzhou Medical Center,Nanjing Medical University,Changzhou,Jiangsu 213000,China)

机构地区：[1]常州市妇幼保健院医学遗传科,江苏常州213000 [2]南京医科大学常州医学中心,江苏常州213000

出　　处：《国际检验医学杂志》2024年第16期1921-1924,共4页International Journal of Laboratory Medicine

基　　金：国家自然科学青年基金项目(82103853);南京医科大学常州医学中心项目(CMCB202206);常州市应用基础研究项目(CJ20230078)。

摘　　要：目的探讨高龄孕妇雄激素水平与不良妊娠结局的关系。方法选取2022年5-10月在常州市妇幼保健院收治入院待分娩的孕妇共192例作为研究对象。研究对象根据妊娠期高血压疾病诊治指南及孕妇年龄分为单纯高龄组、高龄并发妊娠期高血压疾病组、健康对照组、适龄并发妊娠期高血压疾病组。采用化学发光法检测各组血清5种雄激素[血清总睾酮(TT)、性激素结合球蛋白(SHBG)、游离睾酮指数(FTI)、硫酸脱氢表雄酮(DHEAS)和雄烯二酮(A2)]水平。结果与健康对照组比较,适龄并发妊娠期高血压疾病组TT、A2、FTI显著增高,SHBG显著降低;单纯高龄组DHEAS水平降低,差异有统计学意义(P<0.05)。Pearson相关性分析显示,TT与研究对象年龄呈负相关(P<0.05),与收缩压、舒张压和体重指数呈正相关(P<0.05),与子代性别、子代体重无相关性(P>0.05)。多因素Logistic回归分析,发现TT和体重指数为孕妇发生妊娠期高血压疾病的独立危险因素(P<0.05)。结论高龄孕妇雄激素水平与孕妇发生妊娠期高血压疾病有关。Objective To explore the relationship between androgen level and adverse pregnancy outcome of pregnant women at advanced maternal age.Methods A total of 192 pregnant women who were admitted to Changzhou Maternal and Child Health Care Hospital for delivery from May to October 2022 were selected as the study objects.According to guidelines for diagnosis and treatment of hypertensive disorder complicating pregnancy and maternal age,the study objects were divided into simple pregnant women at advanced maternal age group,pregnant women at advanced maternal age complicated with hypertensive disorder complicating pregnancy,healthy control group and age-appropriate pregnant women complicated with hypertensive disorder complicating pregnancy group.Serum levels of five androgens[total testosterone(TT),sex hormone binding globulin(SHBG),free testosterone index(FTI),dehydroepiandrosterone sulfate(DHEAS)and androstendione(A2)]in each group were detected by chemiluminescence method.Results Compared with the healthy control group,TT,A2,FTI were significantly increased and SHBG was significantly decreased in the age-appropriate pregnant women complicated with hypertensive disorder complicating pregnancy group,the level of DHEAS was decreased in the simple pregnant women at advanced maternal age group,and the differences were statistically significant(P<0.05).Pearson correlation analysis showed that TT was negatively correlated with age(P<0.05),positively correlated with systolic blood pressure,diastolic blood pressure and body mass index(P<0.05),and had no correlation with offspring sex and offspring weight(P>0.05).Multivariate Logistic regression analysis showed that TT and body mass index were independent risk factors for hypertensive disorder complicating pregnancy in pregnant women(P<0.05).Conclusion The level of androgen in pregnant women at advanced maternal age is related to the occurrence of hypertensive disorder complicating pregnancy.

关 键 词：高龄孕妇 雄激素 总睾酮 不良妊娠结局 

分 类 号：R714.8[医药卫生—妇产科学]