孕齡、年齡、體重對產(chǎn)前篩查影響的研究
發(fā)布時間：2019-05-03 18:59
【摘要】：目的 研究早孕期和中孕期產(chǎn)前篩查唐氏綜合征、愛德華綜合征和開放性神經(jīng)管缺陷風險值與孕婦年齡、體重、孕齡的關系,探討影響產(chǎn)前篩查的因素,從而避免相關因素的影響,降低產(chǎn)前篩查的假陰性和假陽性,提高產(chǎn)前篩查的準確率。 研究對象和方法 回顧性分析在2011年1月至2012年12月進行早中孕期產(chǎn)前篩查的健康單胎妊娠孕婦共73789例。用全自動時間分辨熒光免疫分析儀檢測孕婦血清中妊娠相關血漿蛋白A(PAPP-A)、甲胎蛋白(AFP)、游離人絨毛膜促性腺激素β-亞單位(Free-βhCG)、游離雌三醇(uE3)水平,應用風險評估軟件系統(tǒng),結合孕婦年齡、體重、孕周等因素校正后分別得出3種先天缺陷的風險值,采用x2檢驗和相關性分析進行數(shù)據(jù)的統(tǒng)計分析。 結果 1.早孕期12042例孕婦共篩查出唐氏綜合征陽性668例,占5.54%(668/12042)；愛德華綜合征陽性80例,占0.66%(80/12042)。中孕期61747例孕婦共篩查出唐氏綜合征陽性4896例,占7.92%(4896/61747)；開放性神經(jīng)管缺陷高風險392例,占0.63%(392/61747)；愛德華綜合征陽性385例,占0.62%(385/61747)。 2.早孕期妊娠相關蛋白A(PAPP-A)中位數(shù)濃度值隨著孕齡的增加逐漸升高,早孕期和中孕期游離人絨毛膜促性腺激素β-亞單位(Free-βhCG)中位數(shù)濃度值均隨著孕齡增加逐漸下降,中孕期甲胎蛋白(AFP)中位數(shù)濃度值隨著孕齡的增加逐漸升高,游離雌三醇(uE3)中位數(shù)濃度值隨著孕齡的增加逐漸升高；各血清學指標的中位數(shù)濃度值均隨著孕婦體重的增加而逐漸下降。 3.唐氏綜合征及愛德華綜合征的假陽性率與年齡相關(均P0.05),均隨年齡增大篩查陽性率增高,且在孕婦年齡在30歲以上的各組間篩查高風險率明顯升高,而ONTD假陽性率則在各年齡組間無統(tǒng)計學差異(P0.05)。體重因素,三種疾病篩查風險值均與體重相關(r=0.018)。孕齡因素,ONTD的檢出與孕齡相關(P0.05),唐氏綜合征及愛德氏綜合征的檢出與孕齡無關(均P0.05)。 結論 1.唐氏綜合征及愛德華綜合征的篩查風險值與孕婦年齡相關,均隨年齡增大篩查陽性率增高；而ONTD風險值與孕婦年齡無相關性。這三種疾病篩查風險值受到孕婦體重的影響。ONTD的檢出與孕周相關,唐氏綜合征及愛德氏綜合征的檢出與孕周不相關。 2.孕周、體重、年齡均會對唐氏綜合征篩查的結果有影響,因此在臨床工作中要準確掌握并填寫進行產(chǎn)前篩查孕婦的相關信息,才能提高產(chǎn)前篩查的效率。
[Abstract]:Objective to study the relationship between the risk of Down's syndrome, Eduard's syndrome and open neural tube defects in early and middle trimester of pregnancy and the age, weight and gestational age of pregnant women, and to explore the factors influencing prenatal screening. So as to avoid the influence of related factors, reduce the false negative and false positive of prenatal screening, and improve the accuracy of prenatal screening. Participants and methods A retrospective analysis of 73789 healthy singleton pregnant women undergoing prenatal screening during early and middle pregnancy from January 2011 to December 2012 was conducted. Pregnancy-associated plasma protein A (PAPP-A) and alpha-fetoprotein (AFP), free human chorionic gonadotropin 尾-subunit (Free- 尾-hCG) were detected by automatic time-resolved fluorescence immunoassay. Free estriol (uE3) level, risk assessment software system, combined with pregnant women's age, body weight, gestational weeks and other factors were adjusted to obtain the risk values of three kinds of congenital defects, using x2 test and correlation analysis for statistical analysis of the data. Outcome 1. A total of 668 cases (5.54%) were positive for Down's syndrome and 80 cases (0.66%) were positive for Edward's syndrome during the first trimester of pregnancy. 4896 cases (7.92%) were positive for Down's syndrome, and 392 cases (0.63%) were at high risk of open neural tube defects (392%, 392%), and 392 cases (0.63%) were found to be positive for Down's syndrome in 61747 pregnant women during the second trimester of pregnancy. The positive rate of Eduard's syndrome was 0.62% (385 / 61747). 2. The median concentration of pregnancy-associated protein A (PAPP-A) in the first trimester increased with the increase of gestational age. The median concentration of free human chorionic gonadotropin 尾-subunit (Free- 尾-hCG) decreased gradually with the increase of gestational age, and the median concentration of alpha-fetoprotein (AFP) increased with the increase of gestational age. The median concentration of free estriol (uE3) increased with the increase of gestational age. The median concentration of each serological index decreased with the increase of pregnant women's weight. 3. The false positive rates of Down's syndrome and Edward's syndrome were correlated with age (P0.05), and the positive rate of screening increased with age, and the high risk rate of screening among pregnant women over 30 years old was significantly higher than that of normal women (P < 0.05). There was no significant difference in the false positive rate of ONTD among different age groups (P0.05). Weight factors, screening risk values for all three diseases were associated with weight (r = 0.018). Gestational age factors, the detection of ONTD was correlated with gestational age (P0.05), Down's syndrome and Edwards syndrome were not associated with gestational age (all P0.05). Conclusion 1. The screening risk of Down's syndrome and Edward's syndrome was correlated with the age of pregnant women, and the positive rate of screening increased with age, but the risk of ONTD was not correlated with the age of pregnant women. The detection of ONTD was correlated with gestational weeks, while Down's syndrome and Edwards' syndrome were not associated with gestational weeks. 2. Gestational weeks, weight and age all affect the results of Down's syndrome screening. Therefore, it is necessary to accurately grasp and fill in the relevant information of prenatal screening for pregnant women in clinical work, in order to improve the efficiency of prenatal screening.
【學位授予單位】：昆明醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R714.5
本文編號：2469187
[Abstract]:Objective to study the relationship between the risk of Down's syndrome, Eduard's syndrome and open neural tube defects in early and middle trimester of pregnancy and the age, weight and gestational age of pregnant women, and to explore the factors influencing prenatal screening. So as to avoid the influence of related factors, reduce the false negative and false positive of prenatal screening, and improve the accuracy of prenatal screening. Participants and methods A retrospective analysis of 73789 healthy singleton pregnant women undergoing prenatal screening during early and middle pregnancy from January 2011 to December 2012 was conducted. Pregnancy-associated plasma protein A (PAPP-A) and alpha-fetoprotein (AFP), free human chorionic gonadotropin 尾-subunit (Free- 尾-hCG) were detected by automatic time-resolved fluorescence immunoassay. Free estriol (uE3) level, risk assessment software system, combined with pregnant women's age, body weight, gestational weeks and other factors were adjusted to obtain the risk values of three kinds of congenital defects, using x2 test and correlation analysis for statistical analysis of the data. Outcome 1. A total of 668 cases (5.54%) were positive for Down's syndrome and 80 cases (0.66%) were positive for Edward's syndrome during the first trimester of pregnancy. 4896 cases (7.92%) were positive for Down's syndrome, and 392 cases (0.63%) were at high risk of open neural tube defects (392%, 392%), and 392 cases (0.63%) were found to be positive for Down's syndrome in 61747 pregnant women during the second trimester of pregnancy. The positive rate of Eduard's syndrome was 0.62% (385 / 61747). 2. The median concentration of pregnancy-associated protein A (PAPP-A) in the first trimester increased with the increase of gestational age. The median concentration of free human chorionic gonadotropin 尾-subunit (Free- 尾-hCG) decreased gradually with the increase of gestational age, and the median concentration of alpha-fetoprotein (AFP) increased with the increase of gestational age. The median concentration of free estriol (uE3) increased with the increase of gestational age. The median concentration of each serological index decreased with the increase of pregnant women's weight. 3. The false positive rates of Down's syndrome and Edward's syndrome were correlated with age (P0.05), and the positive rate of screening increased with age, and the high risk rate of screening among pregnant women over 30 years old was significantly higher than that of normal women (P < 0.05). There was no significant difference in the false positive rate of ONTD among different age groups (P0.05). Weight factors, screening risk values for all three diseases were associated with weight (r = 0.018). Gestational age factors, the detection of ONTD was correlated with gestational age (P0.05), Down's syndrome and Edwards syndrome were not associated with gestational age (all P0.05). Conclusion 1. The screening risk of Down's syndrome and Edward's syndrome was correlated with the age of pregnant women, and the positive rate of screening increased with age, but the risk of ONTD was not correlated with the age of pregnant women. The detection of ONTD was correlated with gestational weeks, while Down's syndrome and Edwards' syndrome were not associated with gestational weeks. 2. Gestational weeks, weight and age all affect the results of Down's syndrome screening. Therefore, it is necessary to accurately grasp and fill in the relevant information of prenatal screening for pregnant women in clinical work, in order to improve the efficiency of prenatal screening.
【學位授予單位】：昆明醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R714.5
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