The predictive value of plasma cell-free fetal DNA concentration combined with serum pregnancy-associated plasma protein-A and β-human chorionic gonadotropin detection for adverse pregnancy outcomes of pregnant women
Objective To explore the predictive value of plasma cell-free fetal DNA(cff-DNA)concentration combined with serum pregnancy-associated plasma protein-A(PAPP-A)and β-human chorionic gonadotropin(β-hCG)detection for adverse pregnancy outcomes of pregnant women.Methods A total of 195 pregnant women who underwent prenatal examination,Down's screening and non-invasive prenatal DNA test(NIPT)in Foshan Fosun Chancheng Hospital from August 2022 to February 2023 were selected as the study subjects.The pregnant women with adverse pregnancy outcomes were set as the study group(n=36),and those without adverse pregnancy outcomes were set as the control group(n=159).The plasma cff-DNA concentration,serum PAPP-A and β-hCG levels of the two groups were detected.Spearman analysis was applied to analyze the correlation between plasma cff-DNA concentration,serum PAPP-A and β-hCG levels and adverse pregnancy outcomes.Receiver operating characteristic(ROC)curve was applied to analyze the predictive value of plasma cff-DNA concentration,serum PAPP-A and β-hCG levels for adverse pregnancy outcomes.Results Compared with the control group,the plasma cff-DNA concentration and serum PAPP-A were significantly lower in the study group(P＜0.05),and the serum β-hCG level was significantly higher(P＜0.05).Spearman analysis showed that the plasma cff-DNA concentration,serum PAPP-A and β-hCG levels were significantly correlated with the adverse pregnancy outcomes of gestational hypertension,preeclampsia,premature delivery,stillbirth,neonatal asphyxia and fetal growth restriction(P＜0.05).ROC curve results showed that the area under the curve of plasma cff-DNA concentration alone for diagnosing adverse pregnancy outcomes of pregnant women was 0.807,and the cut-off value was 11.82％.The area under the curve of serum PAPP-A for the diagnosis of adverse pregnancy outcome of pregnant women alone was 0.804,and the cut-off value was 0.41.the area under the curve of serum β-hCG alone in diagnosing adverse pregnancy outcome of pregnant women was 0.815,and the cut-off value was 2.56.The results of diagnostic efficacy comparison showed that the specificity(97.48％)and accuracy(96.41％)of combined diagnosis of adverse pregnancy outcomes by the combination of plasma cff-DNA concentration,serum PAPP-A and β-hCG levels were obviously higher than those of the three alone(P＜0.05),and the misdiagnosis rate(2.52％)was significantly lower than that of the three alone(P＜0.05).Conclusions Plasma cff-DNA concentration combined with serum PAPP-A and β-hCG detection has high predictive value for the adverse pregnancy outcomes of pregnant women.
Plasma cell-free fetal DNA concentrationPregnancy-associated plasma protein-Aβ-human chorionic gonadotropinAdverse pregnancy outcomePredictive value
万方数据
维普
