孕妇孕中期血清PAPP-A联合Inhibin-A水平预测出生缺陷的临床价值  

Clinical value of the levels of serum pregnancy-associated plasma protein A combined with inhibin-A of women during the second trimester of pregnancy for predicting their birth defects

作　　者：赵金萍 董添 ZHAO Jinping;DONG Tian(Linhai Maternal and Child Health Care Hospital,Taizhou,Zhejiang Province,317000;Hospital of Obstet-rics and Gymecology,Zhejiang University School of Medicime)

机构地区：[1]浙江省临海市妇幼保健院,317000 [2]浙江大学医学院附属妇产科医院

出　　处：《中国计划生育学杂志》2024年第8期1909-1913,共5页Chinese Journal of Family Planning

摘　　要：目的:探讨孕中期孕妇血清妊娠相关蛋白A(PAPP-A)、抑制素A(Inhibin-A)表达水平及其预测出生缺陷的临床价值。方法:收集本院2021年1月—2024年5月定期产前检查并分娩的孕妇临床资料,其中妊娠结局为胎儿结构异常孕妇86例(异常组),妊娠结局为正常新生儿的孕妇90例(对照组),比较两组血清PAPP-A、Inhibin-A水平,Pearson分析异常组血清PAPP-A、Inhibin-A水平相关性,logistic分析发生出生缺陷的影响因素,受试者工作特征曲线分析血清PAPP-A联合Inhibin-A预测出生缺陷的临床价值。结果:异常组血清PAPP-A(7.33±1.48 ng/ml)低于对照组(9.56±1.74 ng/ml),Inhibin-A(478.25±93.48 pg/ml)高于对照组(365.87±81.51 pg/ml)(均P<0.05),异常组血清PAPP-A与Inhibin-A呈负相关(r=-0.340,P=0.001),异常组服用叶酸占比低于对照组,孕早期呼吸道感染、孕期贫血、饲养动物、吸烟占比均高于对照组(均P<0.05);服用叶酸、血清PAPP-A升高是出生缺陷发生的保护因素,孕早期呼吸道感染、孕期贫血、吸烟、血清Inhibin-A升高是出生缺陷发生的危险因素(均P<0.05)。血清PAPP-A预测出生缺陷的曲线下面积(AUC)为0.802,敏感性79.1%、特异性80.0%;血清Inhibin-A预测出生缺陷的AUC为0.803,敏感性74.4%、特异性81.1%,血清PAPP-A联合Inhibin-A预测出生缺陷的AUC为0.874,敏感性91.9%、特异性75.6%(P<0.05)。结论:孕妇孕中期血清PAPP-A降低、Inhibin-A水平升高不利于胎儿正常生长发育,孕中期血清PAPP-A联合Inhibin-A预测出生缺陷临床价值提高,提示临床未来可能用于出生缺陷的临床预测。Objective:To study the clinical value of the levels of serum pregnancy-associated plasma protein A(PAPPA)combined with inhibin-A of women during the second trimester of pregnancy for predicting their birth defects.Methods:The clinical data of the pregnant women who underwent regular prenatal checkups and gave birth from January 2021 to May 2024 were collected.Among them,86 pregnant women with fetal structural abnormalities were in the study group and 90 pregnant women with normal newborns were in the control group.The levels of serum PAPP-A and inhibin-A of the women during the second trimester of pregnancy were compared between the two groups.Pearson analysis was applied to analyze the correlation between the serum PAPP-A level of the women in the study group and their inhibin-A level.Logistic analysis was applied to analyze the influencing factors of the birth defects of the offspring of the women.Receiver operator characteristic(ROC)curve was applied to analyze the clinical value of the combined serum PAPP-A and inhibin-A levels of the women for predicting the birth defects of their offspring.Results:The serum PAPP-A(7.33±1.48 ng/ml)of the women in the study group was significantly lower than that(9.56±1.74 ng/ml)of the women in the control group.The inhibin-A level(478.25±93.48 pg/ml)of the women in the study group was significantly higher than that(365.87±81.51 pg/ml)of the women in the control group(all P<0.05).The serum PAPP-A level of the women in the study group was negatively correlated with their inhibin-A level(r=0.340,P=0.001).The proportion of folic acid intake of the women in the study group was significantly lower than that of the women in the control group.The proportions of the respiratory infections during the first trimester of pregnancy,the anemia during pregnancy,the raising animals and the smoking of the women in the study group were significantly higher than those of the women in the control group(all P<0.05).The folic acid intake and the increased serum PAPP-A level of the women were

关 键 词：出生缺陷 孕中期 妊娠相关蛋白A 抑制素A 血清诊断 

分 类 号：R714.5[医药卫生—妇产科学]