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目的:探讨孕早期血清妊娠相关蛋白-A(pregnancy associatied plasma protein A,PAPP-A)水平对妊娠和围产结局的预测价值。方法:对664例孕4~14周初产妇采用酶联免疫法检测血清PAPP-A水平,并随访该人群至妊娠终止或分娩,分析孕早期血清PAPP-A水平与妊娠和围产结局的关系。结果:①664例初产妇女中,随访到妊娠结局的420例,其中异常妊娠(自然流产、胚胎停止发育)35例(8.33%),建立苏州市围产保健册并成功分娩的385例(91.67%)。②早孕妇女血清PAPP-A水平随孕周的增加而升高。③妊娠结局为异常妊娠的妇女其孕早期血清PAPP-A的中位数倍数值(multiples of the respective normal median,MOM值)水平低于成功分娩者(P<0.05)。④成功分娩孕妇的孕早期血清PAPP-A的MOM值与其早孕期体质量、体质量指数(body mass index,BMI)呈负相关(分别为-0.156,-0.159),与年龄、身高无相关性(P>0.05)。⑤孕早期血清PAPP-A的MOM值与其胎儿性别、出生体质量和分娩方式等无相关性(P>0.05)。结论:孕早期血清PAPP-A水平低常预示早期不良妊娠结局;成功分娩妇女早孕血清PAPP-A水平与其早孕期体质量、BMI呈负相关,但不能预测围产结局。
Objective: To investigate the predictive value of pregnancy associatied plasma protein A (PAPP-A) level in pregnancy in the first trimester of pregnancy and perinatal outcome. Methods: Serum PAPP-A level in 664 primiparages from 4 to 14 weeks pregnant women was measured by enzyme-linked immunosorbent assay. The population was followed up until the termination of pregnancy or childbirth. The relationship between serum PAPP-A level in early pregnancy and pregnancy and perinatal outcome . RESULTS: Among the 664 primipara women, 420 cases of pregnancy outcome were followed, of which 35 cases (8.33%) had abnormal pregnancy (spontaneous abortion and embryo development stopped), 385 cases (91.67% %). ② PAPP-A levels in early pregnant women increased with gestational age. (3) The levels of MOM in PAPP-A in early pregnant women were lower than those in successful delivery (P <0.05) in women with abnormal pregnancy outcome. ④ The MOM value of PAPP-A in the first trimester of pregnancy was negatively correlated with the body mass index (BMI) of the first trimester pregnant women (-0.156, -0.159, respectively), but not with the age and height (P> 0.05). ⑤ MOM value of serum PAPP-A in early pregnancy had no correlation with fetal sex, birth weight and mode of delivery (P> 0.05). CONCLUSIONS: The low serum PAPP-A level in early pregnancy predicts the outcome of early adverse pregnancy. The PAPP-A level of early pregnancy in pregnant women is negatively correlated with the body mass and BMI in early pregnancy, but can not predict perinatal outcome.