孕妇血清PAPPA水平与妊娠并发症的相关性研究

摘要

目的 研究孕妇血清妊娠相关蛋白A(PAPPA)水平与妊娠并发症的相关性.方法 选择2010年9月至2016年12月本院唐氏综合征筛查病例4920例设为观察组,将同时期正常妊娠的2350例妇女设为对照组,收集分析其资料并进行随访,比较两组孕妇血清PAPPA水平.结果 4920例唐氏综合征筛查病例中3400例随访成功,其中孕期及产后正常2145例(63.09％),孕期自然流产或终止妊娠71例(2.09％),先兆流产65例(1.91％),妊娠期高血压综合征48例(1.41％),妊娠期糖尿病99例(2.91％),妊娠期糖耐量异常156例(4.59％).2350例正常妊娠的妇女中1700例随访成功.经统计学分析显示,不同孕周观察组血清PAPPA水平均显著低于对照组(P<0.05);血清PAPPA水平较低时,自然流产或终止妊娠、先兆流产、妊娠期高血压综合征、妊娠期糖尿病和妊娠期糖耐量异常发生率较高.结论 孕妇血清PAPPA水平较低会促进妊娠期并发症如自然流产、先兆流产、妊娠期高血压综合征及妊娠期糖尿病的发生.%Objective To study the correlation between serum pregnancy associated plasma protein A (PAPPA) level of pregnant women and pregnancy complications. Methods From Sep. 2010 to Dec. 2016, 4920 Down syndrome screening cases in our hospital were selected as observation group, and during the same period 2350 normal pregnant women were selected as control group. All the pregnant women were followed up and their data were collected and analyzed, and the serum PAPPA levels in the two groups were compared. Results 3400 cases in the observation group were successfully followed up, including 2145 cases with normal pregnancy and prognosis (63.09％), 71 cases with spontaneous abortion or termination of pregnancy (2.09％), 65 cases with threatened abortion (1.91％), 48 cases with pregnancy induced hypertension syndrome (1.41％), 99 cases with gestational diabetes (2.91％), and 156 cases with gestational impaired glucose tolerance (4.59％). 1700 cases in the control group were successfully followed up. The statistical analysis showed that the serum PAPPA level in the observation group was significantly lower than that in the control group at different gestational weeks (P<0.05). The lower the serum PAPPA level was, the higher the incidences of spontaneous abortion or termination of pregnancy, threatened abortion, pregnancy induced hypertension syndrome, gestational diabetes, and gestational impaired glucose tolerance were. Conclusion The low serum PAPPA level of pregnant women can promote the occurrence of pregnancy complications, such as spontaneous abortion, threatened abortion, pregnancy induced hypertension syndrome, and gestational diabetes.