孕妇年龄与孕中期唐氏综合征产前筛查相关性分析

Analysis on the correlation between pregnant women's age and prenatal screening of Down's syndrome in pregnant metaphase

目的：探讨妊娠中期唐氏综合征产前筛查与孕妇年龄的关系。方法：选择唐山地区门诊自愿接受产前唐氏综合征筛查并住院分娩和接受随访的孕妇5823例，收集孕妇的体重、年龄、预产期及既往不良孕产史等资料。在妊娠15—21周检测母体血清标志物甲胎蛋白（AFP）、游离雌三醇（uE3）和绒毛膜促性腺激素（β-hCG）水平，利用唐氏综合征专用风险评估软件，结合孕妇体重、年龄、孕周进行风险评估，接受唐氏综合征筛查的孕妇其合并危险度〉1／270即视为阳性。将孕妇年龄分为5个组，统计每个组的筛查阳性人数及阳性率，各年龄组之间进行比较。结果：年龄〉35岁的孕妇筛查阳性率均显著高于〈35岁各年龄组（P〈0．05），30～35岁之间孕妇筛查阳性率与〉35岁的孕妇筛查阳性率比较无统计学差异。结论：随着孕妇年龄的逐渐增高，唐氏综合征发生的阳性率随之升高，年龄〉30岁者发生率明显增高，故建议把30岁以上的孕妇纳入唐氏综合征筛查的高危人群。筛查年龄界定为≥30岁，这样能够提高胎儿唐氏综合征的检出率，降低漏诊率，从而有效地降低唐氏儿的出生率。

Objective： To explore the correlation between the pregnant womeng age and prenatal screening of Down g syndrome in pregnant metaphase. Methods： The pregnant women in Tangshan were taken, who was willing to have Downg syndrome screening and will delivery in hospital and accept the follow- up visit, and the data were collected including weight, age, expected date of confinement, the medical history of abnormal pregnancy and birth and so on. During gestational week 15 to 21, serum biochemical markers, namely, AFP, uE3 and[3 -hCG were tested, and then the professional Down g syndrome assessment software was used, combining the factors of pregnant womeng weight, age, and gestational weeks to assess the risk. The combined risk degree of pregnant was more than 1/270, being regarded as positive one. The ages of pregnant women were divided into 5 groups, calculating each group＇s positive number and positive rate after screening, comparison was made between different age groups. Results： The group, more than 35 years old, their positive rate was signifi- cantly higher than other groups under 35 years old, the difference had statistic significance （P 〈 0. 05 ） . However, the group, the age be- tween 30 years old to 35 years old, the positive rate was similar to the group more than 35 years old, without significant difference. Conclusion ： With the growth of pregnant womeng ages, the positive rate of Downg syndrome is increasing. The group, more than 30 years old, occurrence rate of Downg syndrome is obviously higher. Thus, suggest that the pregnant women, over 30 years old, ought to be regarded as the high risk group. The screening age is defined as more than 30 years old so that it will improve the relevance ratio of Downg syndrome, decrease the rate of missed diagnosis, and finally effectively decrease the birth rate of Downg children.