The pregnancy outcome prediction (POP) study: Investigating the relationship between serial prenatal ultrasonography, biomarkers, placental phenotype and adverse pregnancy outcomes
The pregnancy outcome prediction (POP) study: Investigating the relationship between serial prenatal ultrasonography, biomarkers, placental phenotype and adverse pregnancy outcomes
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DOI：
10.1016/j.placenta.2016.10.011
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发表时间：
2017-11
期刊：
影响因子：
3.8
通讯作者：
Smith GC
中科院分区：
文献类型：
--
作者：
Gaccioli F;Lager S;Sovio U;Charnock-Jones DS;Smith GC
胎盘功能障碍与许多与不良母婴结局相关的主要妊娠并发症有关，例如先兆子痫、胎儿生长受限和死产。然而，尽管经过多年的深入研究，这些并发症的筛查仍然主要基于临床依据，而不是胎盘功能的超声和/或生化评估。为数不多的广泛采用的风险评估方法之一，即妊娠早期 PAPP-A（妊娠相关血浆蛋白 A）水平较低，是通过对收集的数据进行二次分析来确定的，以确定筛查唐氏综合症的新方法，而不是有目的地寻找异常胎盘的筛查测试。开发改进的人群筛查方法需要更好地了解导致人类妊娠胎盘相关并发症的途径。除此之外，还需要鉴定反映潜在病理学的生物标志物，同时以高灵敏度和特异性预测相关疾病。在本文中，我们概述了该领域的一些挑战和机遇。此外，我们以怀孕结果预测 (POP) 研究（在英国剑桥进行的一项前瞻性队列研究）为例，说明了如何在研究中解决其中一些问题。
Placental dysfunction is implicated in many major complications of pregnancy associated with adverse maternal and infant outcome, such as preeclampsia, fetal growth restriction and stillbirth. Yet, despite years of intensive research, screening for these complications is still largely based upon clinical grounds rather than ultrasonic and/or biochemical assessment of placental function. One of the few widely employed methods for assessment of risk, low first trimester levels of PAPP-A (Pregnancy Associated Plasma Protein A), was identified through secondary analysis of data collected to identify new methods of screening for Down's syndrome rather than as a purposeful search for screening tests for abnormal placentation. Development of improved methods for population screening requires better mechanistic understanding of the pathways leading to placentally-related complications of human pregnancy. This is in addition to a need for identification of biomarkers which reflect the underlying pathology, while predicting associated disease with high sensitivity and specificity. In this paper, we outline some of the challenges and opportunities in this area. Furthermore, we illustrate how some of these can be addressed in research studies using the example of the Pregnancy Outcome Prediction (POP) study, a prospective cohort study conducted in Cambridge, UK.
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