检验医学 ›› 2014, Vol. 29 ›› Issue (11): 1101-1106.DOI: 10.3969/j.issn.1673-8640.2014.11.006

• 妇儿检验专题 • 上一篇    下一篇

孕中期孕妇体重对血清指标MoM值和三联筛查结果的影响

张彬,刘晓艳   

  1. 复旦大学附属妇产科医院检验科,上海 200011
  • 收稿日期:2014-04-18 出版日期:2014-11-01 发布日期:2014-11-28
  • 作者简介:张彬,女,1969年生,学士,主管技师,主要从事临床检验工作。

Influence of maternal weight on MoM and screening performance in second trimester prenatal triple marker screening

ZHANG Bin, LIU Xiaoyan.   

  1. Department of Clinical Laboratory, the Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China
  • Received:2014-04-18 Online:2014-11-01 Published:2014-11-28
  • Contact: 刘晓艳,联系电话:021-63455050-8224。

摘要:

目的 验证复旦大学附属妇产科医院实验室对孕妇体重校正方法的有效性,并研究孕妇体重对孕中期三联筛查的影响。方法 收集孕中期唐氏综合征筛查标本单妊娠28 577例,采用化学发光免疫分析技术检测血清甲胎蛋白(AFP)、人绒毛膜促性腺激素β亚基(β-hCG)、和游离雌三醇(uE3)的浓度,通过回归体重校正参数,得到体重校正的MoM值,计算唐氏综合征、爱德华氏征和神经管缺陷风险。结果 最合适本实验室的体重校正模型是倒数模型,使用该校正模型,比不校正体重多检出2例21三体的检出率,检出率从65%提高到76%。结论 通过体重校正消除体重对血清标志物含量的影响,进一步提高21三体检出率。各个实验室需要根据当地人群建立自己的体重公式,可以更准确报告唐氏综合征、爱德华氏征和神经管缺陷的风险度。

关键词: 唐氏综合征, 产前筛查, 体重校正, MoM值

Abstract:

Objective To verify the validity of maternal weight adjustment, and to study the influence of maternal weight adjustment on second trimester prenatal triple marker screening in the Obstetrics and Gynecology Hospital of Fudan University. Methods A total of 28 577 second trimester pregnant women were enrolled, and their serum samples were determined by chemiluminescence immunoassay for Down syndrome second trimester prenatal screening with triple markers, alpha fetoprotein (AFP), beta subunit of human chorionic gonadotropin (β-hCG) and unconjugated estriol (uE3). After regressing the maternal weight adjustment parameters, the MoM of maternal weight adjustment was obtained, and the risks of Down syndrome, Edward syndrome and open neural tube disease were calculated. Results Reciprocal-linear was the best fitting model. The reciprocal-linear model detected 2 cases of Down syndrome, thus the detection rate increased from 65% to 76%, comparing to that of no maternal weight adjustment. Conclusions  Maternal weight adjustment can increase the detection rate of Down syndrome as well as diminish the influence of maternal weight on serum marker concentrations. Every laboratory should establish a laboratory-specific maternal weight adjustment to report accurate risk assessment for Down syndrome, Edward syndrome and open neural tube disease.

Key words: Down syndrome, Prenatal screening, Weight adjustment, MoM

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