First-trimester placentation and the risk of antepartum stillbirth
First-trimester placentation and the risk of antepartum stillbirth
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DOI：
10.1001/jama.292.18.2249
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发表时间：
2004-11-10
影响因子：
120.7
通讯作者：
Dobbie, R
中科院分区：
文献类型：
--
作者：
Smith, GCS;Crossley, JA;Dobbie, R
背景早产和低出生体重至少部分是在怀孕的前三个月决定的。然而，目前尚不清楚是否死胎的风险也确定在头三个月的目的，以确定是否产前死胎的风险变化与胎盘功能的循环标志物测量在头三个月的怀孕。设计，设置和参与者多中心，前瞻性队列研究（1998年至2000年在苏格兰进行），7934名妇女在怀孕24周或24周后单胎分娩，在怀孕后的前10周内抽血，结果400例妊娠相关血浆蛋白A（PAPP-A）水平在最低第5百分位数的孕妇中有8例死产，而其余7534例孕妇中有17例死产，其中11例为新生儿，12例为新生儿。每10000名妇女每周妊娠的发病率：分别为13.4 vs 1.4;风险比[HR]，9.2 [95%置信区间{CI}，4.0-21.4]; P
Context Preterm birth and low birth weight are determined, at least in part, during the first trimester of pregnancy. However, it is unknown whether the risk of stillbirth is also determined during the first trimester.Objective To determine whether the risk of antepartum stillbirth varies in relation to circulating markers of placental function measured during the first trimester of pregnancy.Design, Setting, and Participants Multicenter, prospective cohort study (conducted in Scotland from 1998 through 2000) of 7934 women who had singleton births at or after 24 weeks' gestation, who had blood taken during the first 10 weeks after conception, and who were entered into national registries of births and perinatal deaths.Main Outcome Measures Antepartum stillbirths and stillbirths due to specific causes.Results There were 8 stillbirths among the 400 women with levels of pregnancy-associated plasma protein A (PAPP-A) in the lowest fifth percentile compared with 17 among the remaining 7534 women (incidence rate per 10000 women per week of gestation: 13.4 vs 1.4, respectively; hazard ratio [HR], 9.2 [95% confidence interval {CI}, 4.0-21.4]; P