胎儿颈项透明层增厚与高龄孕妇妊娠结局、胎儿结构畸形、染色体核型异常的相关性

Relationship between fetal nuchal translucency thickening and pregnancy outcomes,fetal structural malformations and chromosomal karyotype abnormalities occurred in elderly pregnant women

目的:探讨颈项透明层(nuchal translucency,NT)增厚与高龄孕妇妊娠结局与胎儿结构畸形和染色体核型异常的相关性。方法:回顾性分析2017年至2020年在南京医科大学附属第一医院行NT检查的279例(实访)孕妇围产期的人口学特征、胎儿畸形的发生率、畸形类型、染色体核型结果以及妊娠结局等临床资料,比较高龄和正常龄孕妇妊娠结局中胎儿结构畸形、染色体核型异常与胎儿NT增厚相关性。结果:以NT值2.5 mm为界,结果显示NT正常的孕妇,高龄组97例,结局顺利80例,结局不顺利17例,胎儿结构畸形2例,染色体异常3例;正常龄组84例,结局顺利71例,不顺利13例,胎儿结构畸形0例,染色体异常0例。在NT增厚孕妇中,高龄组49例,妊娠顺利31例,不顺利18例,胎儿结构畸形11例,染色体异常11例;正常龄组49例,妊娠顺利36例,不顺利13例,胎儿结构畸形5例,染色体异常5例。比较NT增厚与正常在高龄与正常龄孕妇的妊娠结局、胎儿结构畸形和染色体核型异常的结果,2组组间差异均有统计学意义(均P<0.05)。结论:NT增厚对高龄与正常龄孕妇妊娠结局、胎儿结构畸形和染色体核型异常均呈负相关关系,且对高龄妊娠孕妇影响更明显。

Objective:To explore the relationship between the thickening of nuchal translucency(NT)and the pregnancy outcome of elderly pregnant women with fetal structural malformation and abnormal chromosome karyotype.Methods:The clinical data of perinatal demographic characteristics,incidence of fetal malformations,types of malformations,chromosome karyotypes and pregnancy outcomes of 279 pregnant women who underwent NT examination in our hospital from 2017 to 2020 were retrospectively analyzed to compare the correlation between fetal structural abnormalities,chromosome karyotype abnormalities and fetal NT thickening in the pregnancy outcome of advanced-age and normal-age pregnant women.Results:The results of this study showed that in 97 pregnant women with normal NT 2.5 mm,there were 80 cases of smooth outcome,17 cases of unsmooth outcome,2 cases of fetal structural malformation,3 cases of chromosome abnormality,84 cases of normal age group,71 cases of smooth outcome,13 cases of unsmooth outcome,0 cases of fetal structural malformation and 0 cases of chromosome abnormality.Among the 49 pregnant women with NT thickening,there were 31 cases of smooth pregnancy,18 cases of unsmooth pregnancy,11 cases of fetal structural malformation,11 cases of chromosome abnormality,49 cases of normal age group,36 cases of smooth pregnancy,13 cases of unsmooth pregnancy,5 cases of fetal structural malformation and 5 cases of chromosome abnormality.The results of pregnancy outcomes,fetal structural malformations and chromosomal karyotype abnormalities were compared between NT thickening and normal in elderly and normal pregnant women,there were statistically significant differences between the two groups(all P<0.05).Conclusion:The thickening of NT was negatively correlated with the pregnancy outcome,fetal structural abnormalities and chromosome karyotype abnormalities between the elderly and normal pregnant women,and the effect was more obvious in the elderly pregnant women.