中孕期孕妇血清胎盘生长因子水平低与胎儿不良预后的关系

Relationship between low level of serum placental growth factor in the second trimester pregnancy women and adverse fetal prognosis

目的探讨中孕期孕妇血清胎盘生长因子(PLGF)水平低与胎儿不良预后的关系。方法选择2023年3月至2024年5月于首都医科大学附属北京友谊医院产科规律产前检查的177例孕妇为研究对象。采用回顾性分析方法,根据中孕期血清PLGF水平,将其分别纳入研究组(n=87,中孕期血清PLGF水平<60 pg/m L)与对照组(n=90,中孕期血清PLGF水平≥60 pg/m L)。收集2组孕妇分娩孕龄、早产率及分娩新生儿出生体重、低出生体重儿发生率、生后1 min Apgar评分、脐动脉血p H值、新生儿窒息发生率,并采用成组t检验或χ^(2)检验,或Fisher确切概率法进行统计学比较。本研究遵循的程序符合2013年新修订的《世界医学协会赫尔辛基宣言》要求。2组孕妇年龄、孕次、产次、早孕期人体质量指数(BMI)等一般临床资料分别比较,差异均无统计学意义(P>0.05)。结果①研究组孕妇分娩孕龄为(33.6±3.1)孕周,低于对照组的(38.3±1.2)孕周,研究组早产率为12.6%(11/87),高于对照组的3.3%(3/90),并且差异均有统计学意义(t=4.45、P<0.001,χ^(2)=5.26、P=0.002)。②研究组新生儿出生体重为(1954±459)g,低于对照组的(2964±283)g,研究组低出生体重儿发生率为13.8%(12/87),高于对照组的2.2%(2/90),并且差异均有统计学意义(t=5.93、P<0.001,χ^(2)=8.13、P<0.001)。③研究组新生儿生后1 min Apgar评分为(7.9±1.7)分,脐动脉血p H值为7.2±0.2,均分别低于对照组的(9.3±1.1)分与7.3±0.1,并且差异均有统计学意义(t=2.25、P=0.038,t=2.16、P=0.045)。④2组新生儿窒息发生率比较,差异无统计学意义(P=0.362)。结论中孕期孕妇血清PLGF水平低与胎儿早产及新生儿出生体重、生后1 min Apgar评分、脐动脉血p H值低等胎儿不良预后有关。临床对于血清PLGF水平低孕妇,需早期识别高危人群,改善新生儿预后。

Objective To investigate the relationship between low level of serum placental growth factor(PLGF)in the second trimester pregnancy women and adverse fetal prognosis.Methods A total of 177 cases of pregnant women who received regular prenatal checkups in the Department of Obstetrics,Beijing Friendship Hospital,Capital Medical University from March 2023 to May 2024 were selected as research subjects.They were grouped into study group(n=87,serum PLGF level<60 pg/m L during the second trimester)and control group(n=90,serum PLGF level≥60 pg/m L during the second trimester)according to the serum PLGF level during the second trimester by retrospective analysis method.The gestational age,premature delivery rate,birth weight of newborn,incidence of low birth weight,Apgar score at 1 min after birth,p H of umbilical artery and incidence of neonatal asphyxia of two groups were collected,and were statistically compared by independent-samples t test or chi-square test or Fisher's exact probability method.This study was in line with the requirements of World Medical Association Declaration of Helsinki Results①The gestational age of study group was(33.6±3.1)gestational weeks,which was lower than that of control group(38.3±1.2)gestational weeks,while the premature delivery rate of study group was 12.6%(11/87),which was higher than that of control group(3.3%,3/90),and both the differences were statistically significant(t=4.45,P<0.001;χ^(2)=5.26,P=0.002).②The birth weight of newborns in study group was(1954±459)g,which was lower than that in control group(2964±283)g,and the incidence of low birth weight infants in study group was 13.8%(12/87),which was higher than that in control group(2.2%,2/90),and both the differences were statistically significant(t=5.93,P<0.001;χ^(2)=8.13,P<0.001).③In study group,the Apgar score at 1 min after birth of neonate was(7.9±1.7)points,and the p H value of umbilical artery blood was 7.2±0.2,which were both lower than those of control group(9.3±1.1)points and 7.3±0.1 respectively,and both the differences were statistically significant(t=2.25,P=0.038;t=2.16,P=0.045).④There was no significant difference in the incidence of neonatal asphyxia between two groups(P=0.362).Conclusions Low level of serum PLGF in the second trimester is associated with adverse fetal prognosis,such as premature birth,low birth weight,low Apgar score at 1 min after birth,and low umbilical cord blood p H value in newborns.For pregnant women with low level of serum PLGF in clinical practice,it is necessary to strengthen prenatal examinations,identify high-risk groups early,so as to improve the prognosis of newborn.