陕西地区26140份孕中期唐氏综合征筛查报告分析

目的 探讨孕中期唐氏综合征筛查报告各指标不同孕周变化趋势和影响因素,建立该地区孕中期不同孕周指标参考区间及中位数参考值,提高筛查效率.方法 选取2015年1月至2019年12月在陕西省人民医院行孕中期唐氏综合征产前筛查的26140例自然妊娠孕妇为研究对象,记录血清生化甲胎蛋白(AFP)、游离雌三醇(uE3)、绒毛膜促性...

Analysis of 26140 cases of second trimester pregnancy Down syndrome screening reports in Shaanxi Province

Objective To explore the change trend and influencing factors of different gestational weeks in the second trimester Down′s syndrome screening report,and to establish the reference interval and median reference value of different gestational weeks indexes in the second trimester in this area for improving the screening efficiency.Methods A total of 26140 natural pregnancy pregnant women undergoing prenatal screening in the second trimester Down′s syndrome prenatal screening in the Shaanxi Provincial People′s Hospital from January 2015 to December 2019 were selected as the research subjects.Serum alpha-fetoprotein(AFP),uncojugated estriol(uE3)and human chorionic gonadotropin(HCG)levels were recorded to describe the reference interval and median of screening indicators for pregnant women of different gestational weeks.The risk rates of 21-trisomy syndrome(DS),18-trisomy syndrome(ES)and open neural tube defect(NTD)were evaluated and calculated by using the software and combining with prenatal examination data.The differences in the detection rates of DS,ES and NTD among different ages,different body masses and different gestational weeks were analyzed.Results The reference intervals and median reference values of serum Down′s syndrome screening indexes for different gestational weeks in the second trimester of pregnancy in this local area were preliminarily established.The AFP and uE3 levels were gradually increased from 14 weeks to 21 weeks of pregnancy,while the HCG level was gradually decreased from 14 weeks to 21 weeks of pregnancy.Among 26140 pregnant women,there were 1841 cases(7.04%)of high-risk DS,166 cases(0.64%)of high-risk ES,and 456 cases(1.74%)of high-risk NTD.There was statistically significant differences in the risk ratio of DS and ES among different age groups,and the risk ratio of DS and ES in the age>35 years old group were higher than those in the other age groups(P<0.05).There was no statistically significant difference in the risk ratio of NTD among different age groups(P=0.12).The difference in the risk rate of DS and ES among pregnant women with different body weights was statistically significant(P<0.05),while the difference in the risk ratio of NTD among different body masses groups was not statistically significant(P=0.62),the risk ratio of DS and ES in the body mass>65 kg group were higher than those in other body mass groups(P<0.05);the differences in the risk ratio of DS,ES and NTD among different gestational weeks were statistically significant(P<0.05).The high risk ratio of DS screening at 14 and 15 weeks of gestation was different from the other gestational weeks(16 to 21 weeks)(P<0.05).The high risk ratio of ES screening at 14 and 15 weeks of gestation was different from 16 to 19 weeks of gestation(P<0.05),while the high-risk ratio of NTD screening only had difference between 15 and 19 weeks of gestation(P<0.05).Conclusion It is of great significance to establish the reference intervals and median reference values of serum Down′s syndrome screening indexes in different gestational weeks of the second trimester in this region;the risk of DS and ES in elderly and high body mass women is increased.The women of childbearing age should grasp the childbearing age and do well the body mass management.The optimal gestational age for screening Down′s syndrome is 16-18 weeks of gestation.