Association between maternal characteristics, abnormal serum aneuploidy analytes, and placental abruption
Association between maternal characteristics, abnormal serum aneuploidy analytes, and placental abruption
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DOI：
10.1016/j.ajog.2014.03.027
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发表时间：
2014-08-01
影响因子：
9.8
通讯作者：
Jelliffe-Pawlowski, Laura L.
中科院分区：
文献类型：
--
作者：
Blumenfeld, Yair J.;Baer, Rebecca J.;Jelliffe-Pawlowski, Laura L.
目的：该研究的目的是检查胎盘功能、母体特征和常规的孕早期和孕中期非整倍体筛查分析物之间的关联。该研究分析了1017名有胎盘早剥的妇女和136,898名无胎盘早剥的妇女，她们有孕早期和孕中期的产前筛查结果，有关联的出生证明，以及一个活产的独生子的出院记录母亲的特点和第一和第二个三个月的非整倍体筛查分析物进行了分析，采用logistic二项式regression.RESULTS：胎盘早剥是更常见的亚洲种族的妇女，年龄大于34岁，妇女与慢性和妊娠相关的高血压，先兆子痫，预先存在的糖尿病，以前的早产，和interpregnancy间隔小于6个月。妊娠早期相关血浆蛋白A第5百分位数或更低，妊娠中期甲胎蛋白第95百分位数或更高，未结合雌三醇第5百分位数或更低，二聚体白蛋白A第95百分位数或更高也与胎盘萎缩相关。当Logistic模型按有无高血压疾病分层时，只有年龄大于34岁的母亲（比值比[OR]，1.4; 95%置信区间[CI]，1.0-2.0），妊娠相关血浆蛋白A ≤第95百分位数（OR，1.9; 95% CI，1.2-3.1），且甲胎蛋白≥第95百分位数（OR，2.3; 95%CI，1.4-3.8）仍然与预防有统计学显著相关。在这项大规模人群队列研究中，无论是否存在高血压疾病，母体非整倍体血清分析物水平异常均与胎盘萎缩相关。
OBJECTIVE: The objective of the study was to examine the association between placental abruption, maternal characteristics, and routine first- and second-trimester aneuploidy screening analytes.STUDY DESIGN: The study consisted of an analysis of 1017 women with and 136,898 women without placental abruption who had first- and second-trimester prenatal screening results, linked birth certificate, and hospital discharge records for a live-born singleton. Maternal characteristics and first- and second-trimester aneuploidy screening analytes were analyzed using logistic binomial regression.RESULTS: Placental abruption was more frequent among women of Asian race, age older than 34 years, women with chronic and pregnancy-associated hypertension, preeclampsia, preexisting diabetes, previous preterm birth, and interpregnancy interval less than 6 months. First-trimester pregnancy-associated plasma protein-A of the fifth percentile or less, second-trimester alpha fetoprotein of the 95th percentile or greater, unconjugated estriol of the fifth percentile or less, and dimeric inhibin-A of the 95th percentile or greater were associated with placental abruption as well. When logistic models were stratified by the presence or absence of hypertensive disease, only maternal age older than 34 years (odds ratio [OR], 1.4; 95% confidence interval [CI], 1.0-2.0), pregnancy-associated plasma protein-A of the 95th percentile or less (OR, 1.9; 95% CI, 1.2-3.1), and alpha fetoprotein of the 95th percentile or greater (OR, 2.3; 95% CI, 1.4-3.8) remained statistically significantly associated for abruption.CONCLUSION: In this large, population-based cohort study, abnormal maternal aneuploidy serum analyte levels were associated with placental abruption, regardless of the presence of hypertensive disease.