ارتباط سطح سرمی پروتئین پلاسمایی A مرتبط با بارداری (PAPP-A) و گنادوتروپین کوریونی β انسانی آزاد (Free βhCG) سه ماهه اول با عوارض بارداری

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشکده پزشکی، دانشگاه شاهد، تهران، ایران

2 گروه پزشکی اجتماعی و اخلاق پزشکی، دانشکده پزشکی، دانشگاه شاهد، تهران، ایران

3 گروه زنان، دانشکده پزشکی، دانشگاه شاهد، تهران، ایران

چکیده

مقدمه و هدف: ارتباط بین مارکرهای غربالگری سه ماهه اول بارداری با افزایش خطر ابتلا به عوارض بارداری گزارش شده است. این مطالعه با هدف تعیین ارتباط سطح سرمی PAPP-A  و βhCG آزاد سه ماهه اول با عوارض بارداری پژوهش انجام شد.
مواد و روش ها: این مطالعه آینده نگر روی 200 مادر باردار مراجعه کننده به بیمارستان شهید مصطفی خمینی تهران از مرداد ماه 1399 تا فروردین 1400 که به دلیل غربالگری آنوپلوئیدی سه ماهه اول در ۱۱-14 هفته، اندازه گیری سطح سرمی PAPP-A و β-hCGآزاد انجام شد. پس از اخذ رضایت نامه کتبی، اطلاعات دموگرافیک و بارداری، نتایج آزمایشات ثبت و تا زمان زایمان پیگیری شدند. وزن زمان تولد نوزاد و سرنوشت بارداری شامل سقط، زایمان زودرس، دیابت بارداری، پره اکلامپسی ثبت شد. با روش های آماری توصیفی و آزمون های تحلیلی تی تست، فیشر، من ویتنی، همبستگی و کای دو نسبت به تعیین ارتباط بین متغیرها اقدام شد.
نتایج: 5/18% (37 نفر) دیابت بارداری، 5/9% (19 نفر)  پره اکلامپسی، 5% (10 نفر) زایمان زودرس و5/1% (3 نفر) سقط داشتند. بین PAPP-A با دیابت بارداری (782/0P=)، پره اکلامپسی (059/0P=)، زایمان زودرس (350/0P=) و وزن کم زمان  تولد (000/1P=) ارتباط معنادار آماری مشاهده نشد. بین میزان β-hCG سرم با دیابت بارداری (271/0P=)، پره اکلامپسی (365/0P=) و زایمان زودرس (000/1P=) و وزن کم نوزاد بدو تولد (2۴1/0P=)، ارتباط آماری وجود نداشت.
نتیجه‌گیری: بین سطح سرمی PAPP-A و β-hCG آزاد با پره اکلامپسی، دیابت بارداری، زایمان زودرس و وزن کم بدو تولد نوزاد ارتباط مشخص وجود ندارد.

کلیدواژه‌ها

عنوان مقاله [English]

The relationship between pregnancy Associated-Plasma-Protein-A (PAPP-A) and free-β-human chorionic gonadotropin (βhCG) levels in the first trimester and pregnancy complications

نویسندگان [English]

  • Marzieh Espid 1
  • Ali Davati 2
  • Ahia Garshasbi 3
1 Faculty of Medicine, Shahed University, Tehran, Iran
2 Department of Social Medicine and Medical Ethics, Shahed University, Tehran, Iran
3 Department of Gynecology and Obstetrics, Faculty of Medicine, Shahed University, Tehran, Iran
چکیده [English]

Background and Objective: The association between screening markers in the first trimester of pregnancy and an increased risk of pregnancy complications has been reported. The aim of this study was to determine the relationship between serum levels of PAPP-A and free βhCG in the first trimester with pregnancy complications.
Materials and Methods: During a prospective study on 200 pregnant women referred to Shahid Mostafa Khomeini Hospital in Tehran from July 2020 to March 2021, due to anoploid screening in the first trimester at 11-14 weeks, serum levels of PAPP-A and free β-hCG were measured. After providing the information, written consent was obtained and demographic and pregnancy information and test results were recorded. All subjects were followed up until delivery. Weight at birth and in case of abortion, preterm delivery, gestational diabetes, preeclampsia, information was recorded. The relationship between PAPP-A and βhCG in the first trimester with pregnancy complications was statistically analyzed using Fisher's exact test.
Results: 18.5% (n=37) had gestational diabetes, 9.5% (n=19) had preeclampsia, 5% (n=10) had preterm labor, and 1.5% (n=3) had abortion. There was no statistically significant relationship between PAPP-A with gestational diabetes (P=0.782), preeclampsia (P=0.059), preterm delivery (P=0.350) and low birth weight (P=1.000). Between serum β-hCG level and gestational diabetes (P=0.271), preeclampsia (P=0.365) and preterm delivery (P=1.000) and low birth weight (P=0.241), statistically significant relationship does not exist.
Conclusion: There is no significant relationship between serum   PAPP-A and βhCG levels with preeclampsia, gestational diabetes, preterm delivery and low birth weight.

کلیدواژه‌ها [English]

  • β-hCG
  • PAPP-A
  • Pregnancy complications
  • Preterm delivery
  • Gestational diabetes
  • preeclampsia

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