孕中期异常甲胎蛋白与不良妊娠结局的相关性

目的探讨孕中期甲胎蛋白(AFP)与不良妊娠结局的相关性,为妊娠管理提供建议。方法对孕中期14 008例孕妇进行唐氏筛查。研究组:①AFP MoM>2.0孕妇338例。②AFP MoM<0.5孕妇224例。依据AFP MoM值不同分组。对照组:AFP MoM值都在正常范围内的孕妇318例。回顾分析妊娠结局资料。结果①AFP MoM>2.0的孕妇发生出生缺陷(P<0.01)的机会明显比正常孕妇高。②AFP MoM>3.5的孕妇发生出生缺陷(P<0.001)和早产(P<0.05)的机会明显比正常孕妇高。③AFP MoM>5.0的孕妇发生出生缺陷(P<0.001)、早产(P<0.01)和胎儿窘迫(P<0.05)的机会明显比正常孕妇高。④AFP MoM<0.5和<0.25的孕妇均未发现与不良妊娠结局相关。结论异常水平的标志物除了能够提供开放性神经管缺损风险外,还能提供不良妊娠结局的风险信息,而这些信息对产前遗传咨询和妊娠管理是非常重要。

The association between second -trimester maternal serum abnormal alpha- fetoprotein and adverse pregnancy out- come.

Objective ： Aim of this study is to determine the association between risk of adverse pregnancy outcome and abnormal maternal serum alpha - fetoprotein in second trimester screening. Abnormal levels of maternal serum markers provide information which is important for counseling and pregnancy management. Methods： A total of 14 008 pregnant women underwent maternal serum Down＇ s syndrome screening. Study groups include： （1） 338 cases were found to have a serum AFP of 〉 2. 0 multiples of the median （MoM）. （2）cases serum were found to have a serum AFP 〈 0. 5 MoM. Pregnant women with abnormal AFP MoM were divided accord- ing to different levels of AFP MoM. 318 cases with normal levels of AFP MoM as control group. All pregnancy outcomes were analyzed retrospectively. Results ： （1） Pregnant women with a serum AFP of 〉 2. 0 MoM have higher occurrence of birth defects （ P 〈 0. 01 ） than normal control study. （2） Pregnant women with a serum AFP of 〉 3.5 MoM have higher occurrence of birth defects （ P 〈 0. 001 ） and preterm labor （ P 〈 0. 05 ）. （3）Pregnant women with a serum AFP of 〉 5.0 MoM have higher occurrence of birth defects （ P 〈 0. 001 ） and preterm labor （ P 〈 0.01 ） and fetal stress （ P 〈 0. 05 ）. （4）Pregnant women with a serum AFP of 〈 0. 5 和 〈 0. 25 MoM were found to have no association with adverse outcomes. Conclusion： Abnormal levels of maternal serum markers can provide risk in- formation of adverse outcomes in addition to the risks for open neural tube defects. The information is important for counseling and pregnancy management.