Second trimester serum predictors of preterm birth in a population-based sample of low-risk pregnancies
Second trimester serum predictors of preterm birth in a population-based sample of low-risk pregnancies
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DOI：
10.1002/pd.2489
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发表时间：
2010-08-01
影响因子：
3
通讯作者：
Currier, Robert J.
中科院分区：
文献类型：
--
作者：
Jelliffe-Pawlowski, Laura L.;Baer, Rebecca J.;Currier, Robert J.
目的探讨在无宫内生长迟缓或其他特殊危险因素的妊娠中，典型采集的孕中期孕妇血清生物标志物与早产的关系。方法纳入102861例无特殊危险因素的单胎妊娠，活产婴儿出生体重正常，无非整倍体或神经管缺陷。使用逻辑二项回归分析来估计与具有正常生物标志物水平的妊娠相比，具有异常水平的甲胎蛋白（AFP）、人绒毛膜促性腺激素（hCG）和/或未结合雌三醇（uE 3）的妊娠中分娩早产的相对风险（RR）。任何生物标志物水平升高[中位数的倍数（MoM）>= 2.01]的妊娠，无论既往分组如何，早产风险均增加（RR 1.3-5.4）。当至少两种生物标志物升高时，早产的风险倾向于大幅增加（RRs2.2 -18.7）。结论妊娠中期母体血清生物标志物可能有助于识别早产风险增加的孕妇时，没有其他确定的风险。数据表明，生物标志物可能特别预测早期早产。版权所有（C）2010约翰威利父子有限公司
Objective To examine the relationship between typically collected second trimester maternal serum biomarkers and preterm birth among pregnancies without intrauterine-growth-retardation or other specific risk factors.Methods Included were 102 861 singleton pregnancies without specific risks that resulted in the live birth of an infant of normal birth weight for gestational age without aneuploidy or a neural tube defect. Logistic binomial regression analyses were used to estimate the relative risk (RR) of giving birth preterit' among pregnancies with an abnormal level of alpha-fetoprotein (AFP), human chorionic gonatotropin (hCG), and/or unconjugated estriol (uE3) compared to pregnancies with normal biomarker levels.Results When compared to pregnancies with normal levels of APP, hCG, and uE3, pregnancies with elevated levels of any biomarker [multiple of the median (MoM) >= 2.01 were at an increased risk for preterm birth regardless of preterit' grouping (RRs 1.3-5.4). Risks for preterm birth tended to increase substantially when at least two biomarkers were elevated (RRs 2.2-18.7).Conclusion The results suggest that second trimester maternal serum biomarkers may help identify pregnancies at increased risk for preterm birth when no other identified risks are present. Data indicates that biomarkers may be particularly predictive of early preterm birth. Copyright (C) 2010 John Wiley & Sons, Ltd.