背景:进行了一项回顾性队列研究,收集2018年1月至2020年12月在杭州妇女医院接受医院分娩的孕妇的数据,并参与了孕中期(15-20+6周)游离β人绒毛膜促性腺激素(游离β-hCG)。探讨孕妇血清游离β-hCG与不良妊娠结局(APO)的关系。
方法:我们回顾性分析了孕妇血清游离β-hCG升高组1978例妇女的临床资料(游离β-hCG≥中位数的2.50倍,MoM)和正常组(0.25MoM≤游离β-hCG<2.50MoM)中的20,767名妇女,来自总共22,745例单胎妊娠,采用改良泊松回归分析计算两组的风险比(RR)和95%置信区间(CI).
结果:游离β-hCG升高组的妊娠和胎次较低,两组之间的差异具有统计学意义(所有,P<0.05)。羊水过多的风险,先兆子痫,和高脂血症,在游离β-hCG水平升高的女性中增加(RRs:1.996,95%CI:1.322-3.014;1.469,95%CI:1.130-1.911和1.257,95%CI:1.029-1.535,所有P<0.05),宫内生长受限(IUGR)和女性婴儿也可能发生(RRs=1.641,95%CI:1.103-2.443和1.101,95%CI:1.011-1.198,均P<0.05)。此外,妊娠中期AFP升高与游离β-hCG水平相关(RR=1.211,95%CI:1.121-1.307,P<0.001)。
结论:APOs,如羊水过多,先兆子痫,和高脂血症,游离β-hCG水平升高的风险增加,IUGR和女婴也可能发生。此外,妊娠中期AFP水平升高和游离β-hCG水平升高之间存在关联.我们建议根据孕妇血清游离β-hCG水平升高和APO的发生情况进行产前监测。
BACKGROUND: A retrospective cohort
study was conducted to collect the data of pregnant women who received hospital delivery in Hangzhou Women\'s Hospital from January 2018 to December 2020, and who participated in the second trimester (15-20+6 weeks) of free beta human chorionic gonadotropin (free β-hCG). And the
study was conducted to explore the relationship between maternal serum free β-hCG and adverse pregnancy outcomes (APO).
METHODS: We retrospectively analyzed the clinical data of 1,978 women in the elevated maternal serum free β-hCG group (free β-hCG ≥ 2.50 multiples of the median, MoM) and 20,767 women in the normal group (0.25 MoM ≤ free β-hCG < 2.50 MoM) from a total of 22,745 singleton pregnancies, and modified Poisson regression analysis was used to calculate risk ratios (RRs) and 95% confidence intervals (CI) of the two groups.
RESULTS: The gravidity and parity in the elevated free β-hCG group were lower, and the differences between the groups were statistically significant (all, P < 0.05). The risks of polyhydramnios, preeclampsia, and hyperlipidemia, were increased in women with elevated free β-hCG levels (RRs: 1.996, 95% CI: 1.322-3.014; 1.469, 95% CI: 1.130-1.911 and 1.257, 95% CI: 1.029-1.535, respectively, all P < 0.05), intrauterine growth restriction (IUGR) and female infants were also likely to happen (RRs = 1.641, 95% CI: 1.103-2.443 and 1.101, 95% CI: 1.011-1.198, both P < 0.05). Additionally, there was an association between elevated AFP and free β-hCG levels in second-trimester (RR = 1.211, 95% CI: 1.121-1.307, P < 0.001).
CONCLUSIONS: APOs, such as polyhydramnios, preeclampsia, and hyperlipidemia, were increased risks of elevated free β-hCG levels, IUGR and female infants were also likely to happen. Furthermore, there was an association between elevated AFP levels and elevated free β-hCG levels in second-trimester. We recommend prenatal monitoring according to the elevated maternal serum free β-hCG level and the occurrence of APO.