■评估一组细胞因子和胎盘功能不全与早产(PTD)的风险。
■BRISA出生队列的嵌套病例对照研究。在200至256周时选择了82对母婴胎盘。使用Luminex流量测量xMAP技术进行循环生物标志物水平。选择分类为Th1、Th2或Th17的细胞因子和其他生物标志物。出生体重与胎盘重量之比(BW/PW)用作胎盘效率的代表。斯皮尔曼相关性,计算单因素分析和逻辑回归模型。灵敏度,特异性,使用受试者工作特征曲线计算正负似然比。
■平均胎龄为250天,14,6%的人小于胎龄,4,8%的大胎龄和13,4%的发育不良。足月新生儿的胎盘效率更高(p<0,001),和18/22(81%)的早产生物标志物值高于对照组。Th1细胞因子高度相关,而在其他生物标志物中观察到最弱的相关性。较少的教育与较高的PTD风险相关(p=0.046),而胎盘功能不全的PTD风险没有明显差异。生物标志物显示PTD的调节OR可忽略不计(0.90至1.02)。IL-6,IL-8,IL-1β,TNFβ,IL-4,IL-13,GCSF,MIP1A,VEGF,EGF,FGF2的灵敏度更高,范围从75.56%到91.11%。
■IL-8,IL-12p40,IL-4,IL-13,GCSF,MIP1B,无症状孕妇的GMSF与PTD相关。这一发现表明母体炎症反应的激活。
UNASSIGNED: To assess a panel of cytokines and placental insufficiency with the risk of preterm delivery (PTD).
UNASSIGNED: Nested case-control study into the BRISA birth cohort. Eighty-two mother-infant-placenta pairs were selected at 20+0 to 25+6 weeks. Circulating biomarker levels were performed using Luminex flowmetric xMAP technology. Cytokines classified as Th1, Th2 or Th17 and other biomarkers were selected. The ratio between birth weight and placental weight (BW/PW) was used as a proxy for placental efficiency. Spearman correlation, univariate analyses and logistic regression models were calculated. Sensitivity, specificity, positive and negative likelihood ratios were calculated using the Receiver Operating Characteristic curve.
UNASSIGNED: Mean gestational age was 250 days, 14,6% were small for gestational age, 4,8% large for gestational age and 13,4% stunted. Placental efficiency was higher for term newborns (p<0,001), and 18/22 (81%) preterm biomarker values were higher than the control group. Th1 cytokines were highly correlated, while the weakest correlation was observed in other biomarkers. Less education was associated with a higher risk of PTD (p = 0.046), while there was no appreciable difference in the risk of PTD for placental insufficiency. Biomarkers showed negligible adjusted OR of PTD (0.90 to 1.02). IL-6, IL-8, IL-1β, TNFβ, IL-4, IL-13, GCSF, MIP1A, VEGF, EGF, and FGF2 presented a higher sensitivity ranging from 75.56% to 91.11%.
UNASSIGNED: IL-8, IL-12p40, IL-4, IL-13, GCSF, MIP1B, and GMSF in asymptomatic pregnant women were associated with PTD. This finding suggests an activation of maternal inflammatory response.