孕中期血β-人绒毛膜促性腺激素水平与不良妊娠结局的关系

The relationship between midtrimester blood human chorionic gonadotropin β-subunit levels and adverse pregnancy outcomes

目的探讨孕中期血绒毛膜促性腺激素(β-HCG)水平异常与子痫前期、胎膜早破、早产等不良妊娠结局之间的关系。方法采用微粒子化学发光免疫技术测定本院217例孕16～22周孕妇血β-HCG水平,追踪观察其妊娠结局,分析β-HCG水平与妊娠结局的关系。结果 217例孕妇中出现子痫前期19例(8.8%),早产18例(8.3%),胎膜早破7例(3.2%),正常孕产妇173例(79.7%);新生儿中有低体重儿2例(0.9%),胎儿窘迫1例(0.5%),死胎1例(0.5%)、新生儿死亡1例(0.5%)。子痫前期组、早产组、胎膜早破组血β-HCG水平与正常孕妇血β-HCG水平比较差异具有统计学意义(P<0.05或P<0.01)。血β-HCG水平大于正常孕妇的2倍中位数者,子痫前期孕妇中有5例(26.3%),早产孕妇中有3例(16.7%),胎膜早破孕妇中有4例(57.1%)。结论孕中期血β-HCG水平的异常改变与不良妊娠结局之间有着密切的关联,可作为预测不良妊娠结局的指标。尤其β-HCG水平大于正常孕妇的2倍中位数时,妊娠风险大大增加。但β-HCG水平异常的原因及导致不良妊娠结局的发病机制有待于进一步研究。

Objective To investigate the relationship between midtrimester blood human chorionic gonadotropin β-subunit （β-HCG） levels and adverse pregnancy outcomes,such as preeclampsia,premature rupture of membranes,and premature birth.Methods Blood β-HCG levels of 217 cases of 16-22 weeks pregnant women were measured using microparticle chemiluminescence immunoassay technology and pregnancy outcomes were traced,and then the relationship between β-HCG levels and pregnancy outcome was analyzed.Results Among 217 cases of pregnant women,preeclampsia occurred in 19 cases （8.8%）,premature delivery occurred in 18 cases （8.3%）,premature rupture of membranes occurred in 7 cases （3.2%）,and 173 cases （79.7%） of pregnant women were normal.Among newborns,there were 2 cases of low birth weight children （0.9%）,1 case of fetal distress （0.5%）,1 case of stillbirth （0.5%）,and 1 case of neonatal deaths （0.5%）.The serum β-HCG levels of preeclampsia group,preterm group,and premature rupture of membranes group were higher than that of the normal pregnant women group,with the difference being statistically significant （P〈0.05 or 0.01）.Among the pregnant women with serum β-HCG levels greater than 2 times the multiple of mean of normal pregnancy women,there were 5 cases in preeclampsia group （26.3%）,3 cases （16.7%） in preterm pregnant group and 4 cases in premature rupture of membranes group （57.1%）.Conclusion Midtrimester serum β-HCG levels are closely linked with adverse pregnancy outcomes,which can be used as indicators for adverse pregnancy outcomes prediction.In particular,β-HCG levels greater than 2 times the multiple of mean of normal pregnancy women,the risk of pregnancy increases greatly.However,the causes of abnormal β-HCG levels and the pathogenesis of adverse pregnancy outcomes remain to be further studied.