中孕期母体血清游离β-HCG水平过高与不良妊娠结局相关性的研究

Association between the abnormal maternal serum free β-HCG levels in second trimester and some adverse pregnancy outcomes

目的:探讨中孕期母体血清人绒毛膜促性腺激素游离β亚基(游离β-HCG)水平异常与早产、出生缺陷、死胎等不良妊娠结局的相关性。方法:回顾分析分娩产妇在中孕期测定的血清游离β-HCG水平,按血清游离β-HCG中位数倍数(MOM)分组,统计分析不同组间早产等不良妊娠结局发生率的差异,探讨不良妊娠结局与中孕期母体血清游离β-HCG水平异常的相关性。结果:中孕期母体血清游离β-HCG过高(≥2.0MOM)的产妇组,早产等不良妊娠结局发生率为31.23%(149/477);母体血清游离β-HCG过低(≤0.5MOM)组,早产等不良妊娠结局发生率为5.12%(29/566);母体血清游离β-HCG正常(0.51～1.99MOM)组中,早产等不良妊娠结局的发生率为1.49%(32/2147)。经Spearman相关性分析,母体血清游离β-HCG水平过高与早产、死胎、肢体畸形、染色体异常等不良妊娠结局的发生显著正相关;母体血清游离β-HCG水平过低与染色体异常发生显著负相关。结论:中孕期孕妇血清游离β-HCG水平过高,与早产、死胎、肢体畸形的发生相关。中孕期孕妇血清游离β-HCG水平过高或过低均提示胎儿患染色体疾病的风险增高。

Objective：To investigate whether the abnormal second trimester maternal serum free β-human chorionic gonadotropin（free β-HCG）levels are associated with preterm birth,birth defects,fetal death and other adverse pregnancy outcomes.Methods：Maternal serum free β-HCG level in the hospital delivery women was measured in the second trimester and retrospectively analyzed incidence of adverse pregnancy outcomes,such as preterm birth,in different groups according to serum free β-HCG multiples of the median（MOM）.Statistical analysis was performed using Spearman correlation analysis.Results：In maternal serum free β-HCG≥2.0MOM group,the incidence of adverse pregnancy outcomes was 31.23%（149/477）;in maternal serum free β-HCG≤0.5MOM group,the incidence of preterm birth and other adverse pregnancy outcomes was 5.12%（29/566）;and in maternal serum free β-HCG 0.51~1.99MOM group,the incidence of adverse pregnancy outcomes was 1.49%（32/2147）.By using spearman＇s rank correlation analysis,we found that there was a significant positive correlation between overhigh second trimester maternal serum free β-HCG level and preterm birth,fetal death,fetal chromosomal diseases and limb malformations;but there was a greatly negative correlation between over low second trimester maternal serum free β-HCG level and the incidence of fetal chromosomal diseases.Conclusions：Overhigh second trimester maternal serum free β-HCG level is related with incidence of preterm birth,fetal death and limb malformation.Overhigh or overlow second trimester maternal serum free β-HCG level is an indication of increased risk of fetal chromosomal diseases.