孕早期末游离人绒毛膜促性腺激素β亚基、母体妊娠相关血浆蛋白A和颈部半透明厚度与胎儿宫内发育迟缓及其他妊娠不良结局的相关性研究

作     者：Krantz D. Goetzl L. Simpson J.L. 侯巍 

出 版 物：《世界核心医学期刊文摘（妇产科学分册）》 (Core Journal in Obstetrics/Gynecology)

年 卷 期：2005年第1卷第3期

页      面：20-21页

学科分类：1002[医学-临床医学] 100211[医学-妇产科学] 10[医学] 

主　　题：妊娠不良结局 染色体异常 异常染色体 筛查指标 百分位数 畸形发生率 指标水平 周前 预测价值 人类发展学 

摘      要：The purpose of this study was to determine the association between first trimester trisomy 21 screening markers (free human chorionic gonadotropin- β ., pregnancy associated plasma protein A , and nuchal translucency) and adverse pregnancy outcome. This was a cohort study of 8012 patients enrolled in a National Institute of Child Health and Human Development sponsored study of first trimester trisomy 21 and 18 screening. Trisomy 21 and 18 risk results and individual marker levels in unaffected pregnancies and pregnancies with adverse outcomes were evaluated. PAPP- A 99th percentile (OR 3.5, 95% CI 1.1- 11.3) were associated with increased risk of preterm delivery before 34 weeks. Increased risk at screening for trisomy 21 and 18 identified 16 of the 29 other chromosomal abnormalities (55% ). Low free β - hCG, low PAPP- A, and increased nuchal translucency were all associated with an increased rate of fetal abnormality. Extreme values of first trimester free β - hCG, PAPP- A, and nuchal translucency are all associated with adverse outcomes. The especially high predictive value for IUGR of PAPP- A levels below the 1st percentile suggests that patients within this group may benefit from increased surveillance for this condition.