摘要
目的探讨孕妇在孕早期每周的雌二醇(E2)、β人促绒毛膜促性腺激素(β-hCG)、孕酮(P)水平与妊娠结局的关系。方法回顾性分析2016年1月至2021年6月于湖北妇幼保健院进行妊娠监测妇女的491例临床资料,根据妊娠结局将孕妇分为继续妊娠组(396例)及流产组(95例),比较两组孕妇每周的β-hCG、P、E2水平来评估其对妊娠结局的影响,应用受试者操作特征(ROC)曲线评价预测结局效果。结果第4周继续妊娠组E2水平显著高于流产组,第5~9周继续妊娠组β-hCG、P、E2水平显著高于流产组,均有统计学意义(P<0.05)。β-hCG、P、E2均是预测妊娠结局的良好指标,联合预测价值>E2>β-hCG>P。结论β-hCG、E2、P水平的维持与早期妊娠的结局有一定的相关性,三项激素水平过低可能导致不良妊娠结局。在胎盘完全形成之前,对早孕期孕妇(尤其是有复发流产病史的孕妇)血清β-hCG、E2、P值进行动态监测,结合其每周最佳界值综合分析,对于临床诊断及临床干预有重要意义。对于监测雌孕激素低的孕妇补充雌孕激素可能有利于胚胎发育。
Objective To investigate the relationship between the levels of estradiol(E2), β-human chorionic gonadotropin(β-hCG), progesterone(P), and pregnancy outcome. Methods The clinical data of 491patient monitored in Hubei Maternal and Child Health Hospital from January 2016 to June 2021 were retrospectively analyzed. They were divided into two groups, according to pregnancy outcome: Continuing pregnancy group(396 cases) and abortion group(95cases). The weekly β-hCG, P and E2 levels of pregnant women in the two groups were compared to evaluate their influence on pregnancy outcome.Receiver operator characteristic(ROC) curve was used to evaluate the predictive values. Results The levels of and E2 in the 4weeks continued pregnancy group were significantly higher than those in the abortion group, the levels of β-hCG, P and E2 in the 5-9 weeks continued pregnancy group were significantly higher than those in the abortion group, and the difference was statistically significant(P<0.05). β-hCG, P and E2 were good indicators for predicting pregnancy outcome, and the predictive value was combined diagnosis >E2>β-hCG>P. Conclusion The maintenance of β-hCG, E2 and P levels has certain correlation with the outcome of early pregnancy. The low levels of three hormones may lead to adverse pregnancy outcome. Before complete placenta formation, combined with comprehensive analysis of their weekly optimal threshold, dynamic monitoring of serum β-HCG, E2 and P values of pregnant women in early pregnancy(especially those with a history of recurrent abortion) is of great significance for clinical diagnosis and clinical intervention. Estrogen and progesterone supplementation in pregnant women monitored for low estrogen and progesterone may be good for embryonic development.
作者
杨正一
朱颜颜
金志春
YANG Zhengyi;ZHU Yanyan;JIN Zhichun(Department of Reproductive,Maternal and Child Health Hospital of Hubei Province,Tongji Medical College of Huazhong University of Science and Technology,Wuhan,Hubei 430070,China)
出处
《中国优生与遗传杂志》
2022年第6期971-977,共7页
Chinese Journal of Birth Health & Heredity
基金
湖北省卫生健康委重点科研项目(WJ2017Z019)。
关键词
孕酮
雌二醇
妊娠结局
预测
最佳界值
progesterone
estradiol
pregnancy outcome
prediction
best cut-off point
