Association Analysis between Maternal Serum Biomarkers and Fetal Congenital Heart Disease.

IF 0.7 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Heart Surgery Forum Pub Date : 2023-10-25 DOI:10.59958/hsf.6703
Hong Jiang, Yuan Lin, Xinqin He
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Abstract

Objective: To investigate the association of maternal serum biomarkers alpha fetal protein (AFP), β-human chorionic gonadotropin (HCG) and unconjugated estriol 3 (uE3) in the second trimester with fetal congenital heart disease (CHD) in low risk populations during the screening of Down's syndrome.

Methods: 109 cases diagnosed with fetal CHD in the second trimester by fetal echocardiography were enrolled as the CHD group. Pregnancy- and gestational-age matched 344 cases without fetal CHD were used as the control group. The values of maternal serum biomarkers HCG, AFP and uE3 were tested and the association with CHD was analyzed.

Results: The means of HCG multiple of median (MoM) and AFP MoM were higher, while the mean of uE3 MoM was lower in the CHD group than those of the control group (p < 0.05). The number of cases with HCG MoM ≥85% quantile, AFP MoM ≥85% quantile was more, while that with uE3 MoM ≤15% quantile was less in the CHD group than that of the control group (p < 0.05). The univariate logistic regression analysis showed that fetal CHD was associated with high values of HCG MoM and AFP MoM and low value of uE3 MoM as well as the HCG MoM ≥85% quantile, AFP MoM ≥85% quantile and the uE3 MoM ≤15% quantile. The multivariate logistic regression analysis showed that HCG MoM ≥85% quantile and AFP MoM ≥85% quantile or the uE3 ≤15% quantile were the independent factors of fetal CHD. In addition, the risk of fetal CHD was higher when one situation existed among the HCG MoM ≥85% quantile, AFP MoM ≥85% quantile and the uE3 MoM ≤15% quantile. The risk of fetal CHD was much higher when both the HCG MoM ≥85% quantile and AFP MoM ≥85% quantile existed or both the HCG MoM ≥85% quantile and the uE3 MoM existed ≤15% quantile.

Conclusions: Second trimester maternal serum biomarkers may be useful indicators for fetal evaluation for CHD to screen positive pregnancies without identified chromosomal defects.

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母体血清生物标志物与胎儿先天性心脏病的相关性分析。
目的:在唐氏综合征筛查期间,探讨妊娠中期母体血清生物标志物α-胎儿蛋白(AFP)、β-人绒毛膜促性腺激素(HCG)和非偶联雌三醇3(uE3)与胎儿先天性心脏病(CHD)的关系。方法:将109例经胎儿超声心动图诊断为妊娠中期胎儿CHD的患者作为CHD组。妊娠和孕龄匹配的344例无胎儿CHD的患者作为对照组。检测母体血清生物标志物HCG、AFP和uE3的值,并分析其与CHD的关系。结果:CHD组中位HCG倍数(MoM)和AFP MoM均值均高于对照组,而uE3 MoM均值低于对照组(p<0.05),单因素logistic回归分析表明,胎儿CHD与HCG-MoM、AFP-MoM值高、uE3-MoM值低、HCG-MoM≥85%、AFP-MoM≥85%、uE3-MoM≤15%有关。多元logistic回归分析表明,HCG-MoM≥85%分位数和AFP-MoM≥85%分位数或uE3≤15%分位数是胎儿CHD的独立因素。此外,当HCG MoM≥85%分位数、AFP MoM≥85%分位数和uE3 MoM≤15%分位数中存在一种情况时,胎儿CHD的风险更高。当HCG-MoM≥85%分位数和AFP-MoM≥85%分位数同时存在时,或当HCG-MoM≥85%分位数和uE3 MoM均存在≤15%分位数时,胎儿CHD的风险要高得多。结论:孕中期孕妇血清生物标志物可能是胎儿评估CHD的有用指标,以筛查没有明确染色体缺陷的阳性妊娠。
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来源期刊
Heart Surgery Forum
Heart Surgery Forum 医学-外科
CiteScore
1.20
自引率
16.70%
发文量
130
审稿时长
6-12 weeks
期刊介绍: The Heart Surgery Forum® is an international peer-reviewed, open access journal seeking original investigative and clinical work on any subject germane to the science or practice of modern cardiac care. The HSF publishes original scientific reports, collective reviews, case reports, editorials, and letters to the editor. New manuscripts are reviewed by reviewers for originality, content, relevancy and adherence to scientific principles in a double-blind process. The HSF features a streamlined submission and peer review process with an anticipated completion time of 30 to 60 days from the date of receipt of the original manuscript. Authors are encouraged to submit full color images and video that will be included in the web version of the journal at no charge.
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