Midtrimester urine human chorionic gonadotropin β-subunit core fragment levels and the subsequent development of preeclampsia
Midtrimester urine human chorionic gonadotropin β-subunit core fragment levels and the subsequent development of preeclampsia
复制标题
DOI：
10.1016/s0002-9378(98)70074-2
复制
发表时间：
1998-09-01
影响因子：
9.8
通讯作者：
Cole, L
中科院分区：
文献类型：
--
作者：
Bahado-Singh, RO;Oz, U;Cole, L
目的：我们的目的是确定中期产妇尿人绒毛膜促性腺激素β -亚基核心片段是否预测后来的先兆子痫。研究设计：对347例接受遗传性羊膜穿刺术的中期单胎妊娠患者进行了尿β -核心片段水平标准化以检测肌酐浓度，并以中位数的倍数表达。分析中考虑的所有女性都是不吸烟的白人。分娩后进行产科图表审查，以确定发生先兆子痫的病例。测定不同阈值水平的人绒毛膜促性腺激素β核片段发生子痫前期的风险。结果：产妇的中位年龄为36.0岁，收集尿液时的中位胎龄为16.0周。子痫前期人绒毛膜促性腺激素β -核心片段的中位数水平为1385.5 ng/mg肌酐，而无子痫前期人绒毛膜促性腺激素β -核心片段的中位数水平为1061.2 ng/mg。差异有统计学意义（Mann-Whitney test, P = .03）。β核片段浓度与子痫前期风险之间存在显著的线性关联（Mantel-Haenszel线性关联检验，P = 0.03）。当人绒毛膜促性腺激素β -核心片段水平为中位数的12.0倍时，继发子痫前期的相对危险度和95%置信区间从2.07（1.06 ~ 4.05）增加到大于或等于中位数的4.0倍时的5.17（1.95 ~ 13.7）。结论：临床正常的妊娠中期尿人绒毛膜促性腺激素β -核心片段水平升高的患者随后发生先兆子痫的风险增加。该尿液分析物作为先兆子痫标志物的临床价值有待进一步研究。
OBJECTIVE: Our purpose was to determine whether midtrimester maternal urine human chorionic gonadotropin beta-subunit core fragment predicts later pre-eclampsia.STUDY DESIGN: Urine beta-core fragment levels standardized to spot creatinine concentration and expressed as multiples of the median were prospectively determined in 347 midtrimester singleton pregnancies undergoing genetic amniocentesis. All women considered in the analysis were white and nonsmokers. Obstetric chart review was undertaken after delivery to identify cases in which pre-eclampsia developed. The risk of pre-eclampsia at different threshold levels of beta-core fragment of human chorionic gonadotropin was determined.RESULTS: The median maternal age was 36.0 years, with a median gestational age at urine collection of 16.0 weeks. The median level of the beta-core fragment of human chorionic gonadotropin was 1385.5 ng/mg of creatinine in those with pre-eclampsia, whereas that in those without pre-eclampsia was 1061.2 ng/mg. The difference was significant (Mann-Whitney Utest, P = .03). A significant linear association was found between the beta-core fragment concentration and the risk of pre-eclampsia (Mantel-Haenszel test of linear association, P = .03). The relative risk and 95% confidence interval of subsequent pre-eclampsia increased from 2.07 (1.06 to 4.05) at beta-core fragment levels of human chorionic gonadotropin 12.0 multiples of the median to 5.17 (1.95 to 13.7) at greater than or equal to 4.0 multiples of the median.CONCLUSION: Clinically normal patients with elevated midtrimester levels of urine beta-core fragment of human chorionic gonadotropin are at increased risk for the subsequent development of pre-eclampsia. The clinical value of this urine analyte as a marker for pre-eclampsia needs to be further investigated.