First-trimester placental ultrasound and maternal serum markers as predictors of small-for-gestational-age infants.
First-trimester placental ultrasound and maternal serum markers as predictors of small-for-gestational-age infants.
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DOI：
10.1016/j.ajog.2014.02.033
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发表时间：
2014-09
影响因子：
9.8
通讯作者：
Parry, Samuel
中科院分区：
文献类型：
--
作者：
Schwartz, Nadav;Sammel, Mary D.;Leite, Rita;Parry, Samuel
关键词：
将胎盘的早期直接评估与胎盘发育的间接标记相结合，以确定分娩小于胎龄儿 (SGA10) 的最大风险的妊娠。我们前瞻性地收集了 11-14 周单胎妊娠的 3D 超声体积集、子宫动脉搏动指数 (UtAPI) 和母体血清。离线测量胎盘体积（PV）、商（PQ=PV/胎龄）、平均胎盘和绒毛膜直径（分别为MPD和MCD）以及胎盘形态指数（PMI=MPD/PQ并调整商的横向胎盘尺寸）。检测母体血清中的胎盘生长因子 (PlGF) 和胎盘蛋白 13 (PP13)。这些变量被评估为 SGA10 的预测因子。在该研究纳入的 578 例妊娠中，有 56 例 (9.7%) 分娩了 SGA10。与正常妊娠相比，SGA10 妊娠的 PV、PQ、MPD 和 MCD 显着较小，PMI 较高（均 P<0.001）。调整混杂因素后，每项胎盘测量值仍与 SGA10 显着相关，并且单独使用临床变量显着改善了模型的性能（每项 P<0.04），调整后的 AUC 范围为 0.71 至 0.74。调整混杂因素后，UtAPI 与 SGA10 不再显着相关（P=0.06）。 PlGF 在 SGA10 妊娠中显着较低（P=0.02），并且在调整后的模型中仍然显着，但未能显着提高 AUC 测量的模型的预测性能（P>0.3）。 PP13 与 SGA10 无关（P=0.99）。利用 3 维超声直接评估胎盘大小和形状可以作为构建早期预测 SGA 的多变量模型的基础。
To combine early, direct assessment of the placenta with indirect markers of placental development to identify pregnancies at greatest risk of delivering small-for-gestational age infants (SGA10). We prospectively collected 3D-ultrasound volume sets, uterine artery pulsatility index (UtAPI) and maternal serum of singleton pregnancies at 11–14 weeks. Placental volume (PV), quotient (PQ=PV/gestational age), mean placental and chorionic diameters (MPD and MCD, respectively), and the placental morphology index (PMI=MPD/PQ and adjusts the lateral placental dimensions for quotient) were measured offline. Maternal serum was assayed for placental growth factor (PlGF) and placental protein-13 (PP13). These variables were evaluated as predictors of SGA10. Of the 578 pregnancies included in the study, 56 (9.7%) delivered SGA10. SGA10 pregnancies had a significantly smaller PV, PQ, MPD and MCD and higher PMI compared to normal pregnancies (P<0.001 for each). Each placental measure remained significantly associated with SGA10 after adjusting for confounders and significantly improved the performance of the model using clinical variables alone (P<0.04 for each) with adjusted AUCs ranging from 0.71 to 0.74. UtAPI did not remain significantly associated with SGA10 after adjusting for confounders (P=0.06). PlGF was significantly lower in SGA10 pregnancies (P=0.02) and remained significant in adjusted models, but failed to significantly improve the predictive performance of the models as measured by AUC (P>0.3). PP13 was not associated with SGA10 (P=0.99). Direct assessment of placental size and shape with 3-dimensional ultrasound can serve as the foundation upon which to build a multivariable model for the early prediction of SGA.
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DOI：
10.1034/j.1600-0412.1998.770611.x
发表时间：
1998-07-01
影响因子：
4.3
作者：
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通讯作者：
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影响因子：
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作者：
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影响因子：
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作者：
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通讯作者：
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作者：
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通讯作者：
Kingdom, J. C. P.
影响因子：
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作者：
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通讯作者：
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