妊娠中期唐氏筛查在高龄孕妇产前诊断中的效果研究

Study on the effect of Down's screening in the prenatal diagnosis of elderly pregnant women in the second trimester

目的:探讨妊娠中期唐氏筛查在高龄孕妇产前诊断中的效果。方法:选择2020年1月至2021年10月在本院行产前检查的2000例高龄孕妇为研究组,选择2000例适龄孕妇为对照组。两组孕妇均接受唐氏筛查。比较两组18-三体综合征、唐氏综合征、NTD高风险发生率,以及羊水细胞核型分析结果、不良母婴结局。结果:研究组唐氏综合征高风险率和总筛查高风险率分别为8.35%、12.00%,高于对照组的4.60%、7.00%,差异有统计学意义(P<0.05);两组18-三体综合征、NTD高风险率比较,差异无统计学意义(P>0.05);研究组羊水染色体异常率为3.15%(63/2000),高于对照组的0.60%(12/2000),差异有统计学意义(P<0.05);研究组早产、引产、妊娠合并症、巨大儿发生率和不良母婴结局发生率分别为8.85%、3.15%、3.15%、5.70%、20.85%,均高于对照组的2.40%、1.00%、1.40%、1.60%、6.40%,差异有统计学意义(P<0.05)。结论:高龄孕妇妊娠中期唐氏筛查可准确显示其高风险指征,提高唐氏综合征检出率,可预测高龄孕妇不良妊娠结局风险,值得临床应用。

Objective:To explore the effect of Down's screening in the second trimester of pregnancy in the prenatal diagnosis of elderly pregnant women.Methods:2000 elderly pregnant women who underwent prenatal check-ups in our hospital from January 2020 to October 2021 were selected as the study group,and 2000 pregnant women of appropriate age were selected as the control group.Both groups of pregnant women received Down's screening.The high-risk incidence of trisomy 1818-trisomy syndrome,Down's syndrome,NTD,and the results of amniotic fluid cell karyotype analysis and adverse maternal and infant outcomes were compared between the two groups.Results:The high risk rate of Down syndrome in the study group and the high risk rate of total screening were 8.35%and 12.00%,respectively,which were higher than 4.60%and 7.00%in the control group.The difference was statistically significant(P<0.05);There was no significant difference in the high risk rates of 18-trisomy syndrome and NTD(P>0.05);the abnormal rate of amniotic fluid chromosomes in the study group was 3.15%(63/2000),which was higher than 0.60%(12/2000)in the control group,The difference was statistically significant(P<0.05);the incidence of preterm birth,induction of labor,pregnancy complications,macrosomia,and adverse maternal and infant outcomes in the study group were 8.85%,3.15%,3.15%,5.70%,and 20.85%,respectively.They were all higher than those of the control group of 2.40%,1.00%,1.40%,1.60%,6.40%,and the difference was statistically significant(P<0.05).Conclusion:Down's screening in the second trimester of pregnant women can accurately display high-risk indications and increase the detection rate of Down syndrome.It is worthy of clinical application for predicting the risk of adverse pregnancy outcomes in advanced-age pregnant women.