母体中孕期外周血AFP、hCG水平与PAS关系的Meta分析

Meta Analysis of Relationship Between Maternal AFP,HCG and PAS

目的:探讨母体中孕期外周血甲胎蛋白(AFP)、绒毛膜促性腺激素(hCG)水平与胎盘植入性疾病(PAS)的关系。方法:检索中国知网、万方、维普、PubMed、EMbase、The Cochrane Library等数据库中有关母体中孕期外周血hCG、AFP水平与PAS关系的文献,筛选、评价后纳入文献并提取数据进行Meta分析。结果:共纳入8篇文章,分析结果显示PAS组的AFP水平高于前置胎盘组及正常组,效应量标准化均数差(SMD)合并值分别为0.53(0.18,0.89)、0.70(0.37,1.04),差异有统计学意义(P<0.05);PAS组的hCG水平高于前置胎盘组及正常组,SMD合并值分别为1.16(0.35,1.97)、2.24(1.07,3.81),差异有统计学意义(P<0.05)。结论:母体中孕期外周血AFP、hCG水平升高与PAS相关,有可能成为PAS的预测因子,但目前的研究尚无法辨别植入严重程度。

Objective:To investigate the relationship between maternal serum AFP,hCG levels and placenta accreta spectrum disorders(PAS).Methods:The papers on the relationship between maternal serum hCG,AFP and PAS in mid pregnancy were retrieved from databases such as CNKI,Wanfang,VIP,PubMed,EMBASE and the Cochrane library.The papers were screened,and evaluated.The data were extracted.Results:A total of 8 articles were included.The results show that the level of AFP in PAS group was higher than that in placenta previa group and normal group.The combined values of SMD were 0.53(0.18,0.89)and 0.70(0.37,1.04)respectively,and the difference was statistically significant(P<0.05).The level of hCG in PAS group was higher than that in placenta previa group and normal group.The combined values of SMD were 1.16(0.35,1.97)and 2.24(1.07,3.81)respectively,and the difference was statistically significant(P<0.05).Conclusion:The increase of AFP and hCG in maternal peripheral blood during pregnancy may be related to PAS,but the current study can not identify the severity of implantation.