妊娠中期孕妇血清三联生化标记物在出生缺陷筛查中的应用价值

目的：探讨妊娠中期孕妇血清三联生化标记物在出生缺陷筛查中的应用价值。方法选择我院2014年12月至2015年12月收治的妊娠中期(15~20+6周)孕妇5922例，对所有孕妇进行甲胎蛋白(AFP)、游离人绒毛膜促性腺激素(Free-β-HCG)、游离雌三醇(uE3)等血清生化指标检测，利用产前筛查软件评估其出生缺陷及危险性。结果血清学筛查孕妇中高风险共473例，其中21-三体综合征高风险416例，18-三体综合征高风险5例， NTD高风险52例；不同年龄区间高风险的分布比较差异无统计学意义(P>0.05)；21-三体高风险、18-三体高风险及NTD高风险检出数集中分布于孕周16~19周，检出数分别为416例、5例、52例，三组检出数比较差异无统计学意义(P>0.05)；筛查高风险组妊娠结局异常率3.38%(16/473)，明显高于筛查低风险组的0.99%(54/5449)，差异具有统计学意义(P<0.05)；年龄在20~34岁孕妇出生缺陷异常率为2.03%(118/5812)，低于35~41岁孕妇异常率的4.55%(5/110)，差异具有统计学意义(P<0.05)。结论妊娠中期孕妇血清三联生化标记物作为21-三体综合征、18三体综合征及NTD等重要出生缺陷筛查指标，能有效降低胎儿出生缺陷发生率，对提高人口素质具有积极意义。

Value of serum triple biochemical marker in the screening of birth defects in mid-pregnant women

Objective To discuss the value of serum triple biochemical marker for screening birth defects in mid-pregnant women. Methods A total of 5 922 women in mid-term pregnancy (15~20+6 weeks), who admitted to our hospital from Dec. 2014 to Dec. 2015, were collected. Alpha fetal protein (AFP), free human chorionic gonadotropin (free-β-HCG), unconjugated estriol 3 (uE3) and others serum biochemical indexes of all pregnant women were detected. Birth defects and risks were evaluated by using the software of prenatal screening in all pregnant women. Results Af-ter serological screening, there were 473 cases of high risks, including 416 cases of high risk of Down's syndrome, 5 cas-es of high risk of Edward syndrome, 52 cases of high risk of neural tube defect (NTD). Distribution of high risk in differ-ent age ranges showed no statistically significant difference (P>0.05). The detection of women with high risk of Down's syndrome, Edward syndrome and NTD concentrated in the 16 to 19 weeks gestational age, with the detection number of 416 cases, 5 cases, 52 cases, respectively, with no significant difference between the three groups (P>0.05). The abnormal rate of pregnancy outcome in the high-risk group was significantly higher than that in low risk group, 3.38%(16/473) vs 0.99%(54/5 449), P<0.05. The abnormal rate of birth defects of pregnant women aged 20~34 years was significantly lower than that of pregnant women aged 35~41 years, 2.03%(118/5 812) vs 4.55%(5/110), P<0.05. Conclusion As an important indicator of Down's syndrome, Edward syndrome and NTD, serum triple biochemical marker for screening birth defects can effectively reduce the incidence of birth defects and effectively reduce the incidence of birth defects, which has a positive significance to improve the quality of the population.