Abstract：
OBJECTIVE: To evaluate the performance of maternal factors, biophysical and biochemical markers at 11-13 + 6 weeks\' gestation in the prediction of gestational diabetes mellitus with or without large for gestational age (GDM ± LGA) fetus and great obstetrical syndromes (GOS) among singleton pregnancy following in-vitro fertilisation (IVF)/embryo transfer (ET).
METHODS: A prospective cohort study was conducted between December 2017 and January 2020 including patients who underwent IVF/ET. Maternal mean arterial pressure (MAP), ultrasound markers including placental volume, vascularisation index (VI), flow index (FI) and vascularisation flow index (VFI), mean uterine artery pulsatility index (mUtPI) and biochemical markers including placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) were measured at 11-13 + 6 weeks\' gestation. Logistic regression analysis was performed to determine the significant predictors of complications.
RESULTS: Among 123 included pregnancies, 38 (30.9%) had GDM ± LGA fetus and 28 (22.8%) had GOS. The median maternal height and body mass index were significantly higher in women with GDM ± LGA fetus. Multivariate logistic regression analysis demonstrated that in the prediction of GDM ± LGA fetus and GOS, there were significant independent contributions from FI MoM (area under curve (AUROC) of 0.610, 95% CI 0.492-0.727; p = 0.062) and MAP MoM (AUROC of 0.645, 95% CI 0.510-0.779; p = 0.026), respectively.
CONCLUSIONS: FI and MAP are independent predictors for GDM ± LGA fetus and GOS, respectively. However, they have low predictive value. There is a need to identify more specific novel biomarkers in differentiating IVF/ET pregnancies that are at a higher risk of developing complications.
METHODS: A prospective cohort study was conducted between December 2017 and January 2020 including patients who underwent IVF/ET. Maternal mean arterial pressure (MAP), ultrasound markers including placental volume, vascularisation index (VI), flow index (FI) and vascularisation flow index (VFI), mean uterine artery pulsatility index (mUtPI) and biochemical markers including placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) were measured at 11-13 + 6 weeks\' gestation. Logistic regression analysis was performed to determine the significant predictors of complications.
RESULTS: Among 123 included pregnancies, 38 (30.9%) had GDM ± LGA fetus and 28 (22.8%) had GOS. The median maternal height and body mass index were significantly higher in women with GDM ± LGA fetus. Multivariate logistic regression analysis demonstrated that in the prediction of GDM ± LGA fetus and GOS, there were significant independent contributions from FI MoM (area under curve (AUROC) of 0.610, 95% CI 0.492-0.727; p = 0.062) and MAP MoM (AUROC of 0.645, 95% CI 0.510-0.779; p = 0.026), respectively.
CONCLUSIONS: FI and MAP are independent predictors for GDM ± LGA fetus and GOS, respectively. However, they have low predictive value. There is a need to identify more specific novel biomarkers in differentiating IVF/ET pregnancies that are at a higher risk of developing complications.
摘要：
目的：评估母性因素的表现，妊娠11-13+6周时的生物物理和生化标志物在体外受精(IVF)/胚胎移植(ET)后单胎妊娠中预测妊娠糖尿病伴或不伴大孕龄(GDM±LGA)胎儿和大产科综合征(GOS)。
方法：2017年12月至2020年1月进行了一项前瞻性队列研究，包括接受IVF/ET的患者。产妇平均动脉压(MAP),超声标记包括胎盘体积，血管化指数（VI），血流指数（FI）和血管化血流指数（VFI），在妊娠11-13+6周测量平均子宫动脉搏动指数(mUtPI)和生化标志物,包括胎盘生长因子(PlGF)和可溶性fms样酪氨酸激酶-1(sFlt-1)。进行Logistic回归分析以确定并发症的重要预测因子。
结果：在123例怀孕中，38例(30.9%)胎儿为GDM±LGA，28例(22.8%)胎儿为GOS。GDM±LGA胎儿妇女的中位母亲身高和体重指数明显较高。多因素logistic回归分析显示,在预测GDM±LGA胎儿和GOS时,FIMoM（曲线下面积（AUROC）为0.610，95％CI0.492-0.727；p=0.062）和MAPMoM（AUROC为0.645，95％CI0.510-0.779；p=0.026）有显着的独立贡献，分别。
结论：FI和MAP是GDM±LGA胎儿和GOS的独立预测因子，分别。然而,它们的预测价值很低。需要在区分具有较高并发症风险的IVF/ET妊娠中鉴定更特异性的新型生物标志物。
方法：2017年12月至2020年1月进行了一项前瞻性队列研究，包括接受IVF/ET的患者。产妇平均动脉压(MAP),超声标记包括胎盘体积，血管化指数（VI），血流指数（FI）和血管化血流指数（VFI），在妊娠11-13+6周测量平均子宫动脉搏动指数(mUtPI)和生化标志物,包括胎盘生长因子(PlGF)和可溶性fms样酪氨酸激酶-1(sFlt-1)。进行Logistic回归分析以确定并发症的重要预测因子。
结果：在123例怀孕中，38例(30.9%)胎儿为GDM±LGA，28例(22.8%)胎儿为GOS。GDM±LGA胎儿妇女的中位母亲身高和体重指数明显较高。多因素logistic回归分析显示,在预测GDM±LGA胎儿和GOS时,FIMoM（曲线下面积（AUROC）为0.610，95％CI0.492-0.727；p=0.062）和MAPMoM（AUROC为0.645，95％CI0.510-0.779；p=0.026）有显着的独立贡献，分别。
结论：FI和MAP是GDM±LGA胎儿和GOS的独立预测因子，分别。然而,它们的预测价值很低。需要在区分具有较高并发症风险的IVF/ET妊娠中鉴定更特异性的新型生物标志物。
