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预防医学  2018, Vol. 30 Issue (3): 240-243,247    DOI: 10.19485/j.cnki.issn2096-5087.2018.03.006
  论著 本期目录 | 过刊浏览 | 高级检索 |
早中孕期风险筛查与妊娠结局分析
陈益明, 张闻, 卢莎, 张艳珍, 连结静, 张丽丹, 王敏, 王昊, 梅瑾, 胡文胜
杭州市妇产科医院产前诊断中心,浙江 杭州 310008
Pregnancy outcomes among women with high and low risk in first and second trimester prenatal screening analysis
CHEN Yi-ming, ZHANG Wen, LU Sha, ZHANG Yan-zhen, LIAN Jie-jing, ZHANG Li-dan, WANG Min,WANG Hao,MEI Jin ,HU Wen-sheng
Department of Prenatal Diagnosis Centre,Hangzhou Women's Hospital,Hangzhou,Zhejiang 310008,China
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摘要 目的 了解早中孕期血清学产前筛查风险与孕妇不良妊娠结局的关联性,为合理指导和管理接受血清学产前筛查孕妇提供依据。方法 对杭州市5家产前筛查中心的180 006名早中孕期孕妇进行唐氏综合征(DS)、18三体综合征(ES)和开放性神经管缺陷(ONTD)发病风险的产前筛查和产后随访,比较筛查结果为高风险与低风险孕妇的妊娠结局,并评价产前筛查的诊断价值。结果 检出高风险孕妇10 296例,低风险孕妇169 710例(随访到168 654例);其中DS、ES、ONTD高风险分别为9 406、273和617例,高风险阳性率分别为5.23%、0.15%和0.34%。高风险孕妇早产活产、自然流产、终止妊娠、死胎/死产的发生率分别为5.46%、0.80%、1.80%和0.37%,均高于低风险孕妇的3.50%、0.21%、0.38%和0.18%(P<0.001);高风险孕妇的胎儿DS、ES、ONTD实际发生率分别为4.56‰、1.65‰和0.97‰,均高于低风险孕妇胎儿的0.12‰、0.04‰和0.09‰(P<0.001)。DS、ES、ONTD产前筛查的灵敏度分别为70.15%、68.00%和38.46%,假阳性率分别为5.23%、0.14%和0.34%。结论 血清学产前筛查高风险孕妇的DS、ES、ONTD及不良妊娠结局发生率高,产前筛查的假阳性率较低。
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陈益明
张闻
卢莎
张艳珍
连结静
张丽丹
王敏
王昊
梅瑾
胡文胜
关键词 产前筛查唐氏综合征18三体综合征神经管缺陷不良妊娠结局    
AbstractObjective To analyze adverse pregnancy outcomes among women with high risk and low risk during prenatal screening. Methods Clinical data of 180 006 pregnancies in 5 prenatal screening center in Hangzhou were collected. We compared the adverse pregnancy outcomes of high and low risk pregnancies. Results Among 180 006 pregnancies(age<35 years old),there were 10 296 high-risk cases and 169 710 low-risk cases,with 168 654 cases followed. There were 9 406 high-risk cases of Down's syndrome(DS)(5.23%),273 high-risk cases of Edwards' syndrome(ES)(0.15%)and 617 high-risk cases of open neural tube defect(ONTD)(0.34%). The detection rate of pregnancy outcome of premature birth,spontaneous abortion,termination of pregnancy,stillbirth in the high risk was 5.46%,0.80%,1.80%,0.37%,respectively,and that rate in low risk results was 3.50%,0.21%,0.38%,0.18%,respectively. Adverse pregnancy outcomes in high-risk group were significantly higher than that in low-risk group(all P<0.001). The actual incidence rate of DS,ES or ONTD in high-risk group (4.56‰,1.65‰,0.97‰,respectively)were significantly higher than that in low-risk group(0.12‰,0.04‰,0.09‰,respectively,all P<0.001). The detection rates of prenatal screening were 70.15%,68.00% and 38.46%,and false positive rates were 5.23%,0.14% and 0.34%。Conclusion High risk of serum prenatal screening analysis is associated with adverse pregnancy outcomes. The number of pregnancies experienced invasive prenatal diagnosis can be reduced by routine serum prenatal screening. That is an Effective method to reduce the birth defects.
Key wordsPrenatal screening    Down's syndrome    Edwards' syndrome    Open neural tube defect    Adverse pregnancy outcome
收稿日期: 2017-09-25      修回日期: 2017-12-16      出版日期: 2018-03-06
中图分类号:  R714.55  
作者简介: 胡文胜,E-mail:huws@zju.edu.cn
引用本文:   
陈益明, 张闻, 卢莎, 张艳珍, 连结静, 张丽丹, 王敏, 王昊, 梅瑾, 胡文胜. 早中孕期风险筛查与妊娠结局分析[J]. 预防医学, 2018, 30(3): 240-243,247.
CHEN Yi-ming, ZHANG Wen, LU Sha, ZHANG Yan-zhen, LIAN Jie-jing, ZHANG Li-dan, WANG Min, WANG Hao, MEI Jin , HU Wen-sheng. Pregnancy outcomes among women with high and low risk in first and second trimester prenatal screening analysis. Preventive Medicine, 2018, 30(3): 240-243,247.
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