孕妇孕早期血清PAPP-A与新生儿出生体重的关系

The Association between First Trimester Maternal Serum Pregnancy Associated Plasma Protein A Level and Fetal Birth Weight

目的研究孕早期母亲血清妊娠相关血浆蛋白A(PAPP-A)水平与新生儿出生体重关系。方法回顾性分析北京大学深圳医院2105例单胎妊娠产妇的资料,分析孕早期母亲血清PAPP-A水平与新生儿出生体重的相关性,并通过多因素回归分析出生体重的影响因素,探究低水平PAPPA与小于孕龄儿发病率的关联。结果孕早期母亲血清PAPP-A水平与新生儿出生体重呈显著正相关性(r=0.139,P<0.001);多元线性回归分析结果显示身高、孕前BMI、孕期增重、胎龄及PAPP-A MoM值是新生儿出生体重的独立影响因子(P<0.001);低水平的PAPPA(<第五百分位)增加小于孕龄儿的发病风险(OR 2.86,95%CI 1.69-4.85)。PAPP-A预测SGA的ROC曲线下面积(AUC)为0.626(95%CI,0.583-0.669)。结论孕早期母亲血清PAPP-A水平与新生儿出生体重正相关,低水平的PAPPA(<第五百分位)增加SGA的发病风险,PAPP-A对SGA有预测价值。

Objective To study the association of first trimester maternal serum pregnancy associated plasma protein A(PAPP-A)level with fetal birth weight.Methods The data of 2105 singleton pregnant women who delivered at Peking University Shenzhen Hospital were retrospectively analyzed,and the association between maternal serum PAPP-A level and fetal birth weight was studied.Results There was a significant positive correlation between maternal serum PAPP-A level and fetal birth weight(r=0.139,P<0.001);The result of multiple linear regression analysis showed that height,BMI,weight gain during pregnancy,gestational age and PAPP-A MoM were independent influence factors of fetal birth weight(P<0.001);Low levels of PAPPA(<the 5th percentile)increased the risk of SGA(OR 2.86,95%CI 1.69-4.85).The area under the ROC curve(AUC)when PAPP-A predicts SGA is 0.626(95%Cl,0.583-0.669).Conclusion The maternal serum PAPP-A level in first trimester is positively correlated with the fetal birth weight.The low level PAPP-A(<5th percentile)increases the risk of SGA.PAPP-A has predictive value for SGA.