First-trimester placental protein 13 screening for preeclampsia and intrauterine growth restriction
First-trimester placental protein 13 screening for preeclampsia and intrauterine growth restriction
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DOI：
10.1016/j.ajog.2007.02.025
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发表时间：
2007-07-01
影响因子：
9.8
通讯作者：
Wolf, Myles
中科院分区：
文献类型：
--
作者：
Chafetz, Ilana;Kuhnreich, Ido;Wolf, Myles
目的：本研究的目的是评估孕早期血清胎盘蛋白13（PP 13）作为先兆子痫和宫内生长受限（IUGR）的筛查试验。研究设计：我们进行了一项前瞻性，巢式病例对照研究，在马萨诸塞州总医院产科产妇研究。通过固相夹心酶联免疫吸附测定法测量血清样品中的PP 13，所述血清样品在第一次产前访视（妊娠9-12周）时从随后经历先兆子痫（n = 47）、IUGR（n = 42）或早产（n = 46）的妇女收集。与简单的长期交付的妇女作为对照组（n = 290），并匹配的情况下，胎龄时，血清收集和标本storage.Results的持续时间：中位妊娠早期PP 13水平为132.5 pg/mL的对照组。患有先兆子痫（27.2 pg/ mL; P <0.001）、IUGR（86.6 pg/mL; P <0.001）和早产（84.9 pg/mL; P = 0.007）的妇女中位PP 13水平显著较低。当PP 13表示为对照组中孕龄特异性中位数的倍数时，先兆子痫的中位数倍数为0.2，IUGR为0.6，早产为0.6（与对照组相比，每种疾病的中位数均为P <0.001）。受试者操作特征分析得出先兆子痫、IUGR和早产的曲线下面积分别为0.91、0.65和0.60。在90%的特异性率，相应的敏感性分别为79%，33%，和28%，foreign.CONCLUSION：在孕早期母体PP 13水平的筛查是一个有前途的诊断工具，用于预测先兆子痫具有较高的敏感性和特异性。
OBJECTIVE: The purpose of this study was to evaluate first-trimester serum placental protein 13 (PP13) as a screening test for preeclampsia and intrauterine growth restriction (IUGR).STUDY DESIGN: We performed a prospective, nested case-control study in the Massachusetts General Hospital Obstetric Maternal Study. PP13 was measured by solid- phase sandwich enzyme-linked immunosorbent assay in serum samples that were collected at the first prenatal visit (9-12 weeks of gestation) from women who subsequently experienced preeclampsia (n = 47), IUGR (n = 42), or preterm delivery (n = 46). Women with uncomplicated term deliveries served as control subjects (n = 290) and were matched to cases by gestational age when serum was collected and for the duration of specimen storage.RESULTS: The median first-trimester PP13 level was 132.5 pg/mL in the control subjects. Median PP13 levels were significantly lower among women who had preeclampsia (27.2 pg/ mL; P < .001), IUGR 86.6 pg/mL; P < .001), and preterm delivery (84.9 pg/mL; P = .007). When PP13 was expressed as multiples of the gestational ages-specific medians among the control subjects, the multiples of the medians were 0.2 for preeclampsia, 0.6 for IUGR, and 0.6 for preterm delivery (P < .001 for each disorder compared with control subjects). Receiver operating characteristic analysis yielded areas under the curve of 0.91, 0.65, and 0.60 for preeclampsia, IUGR, and preterm delivery, respectively. At a 90% specificity rate, the corresponding sensitivities were 79%, 33%, and 28%, respectively.CONCLUSION: The screening of maternal PP13 levels in the first trimester is a promising diagnostic tool for the prediction of preeclampsia with high sensitivity and specificity.