一项关于足月妊娠中因胎儿窘迫导致的胎儿脐动脉 N 末端前脑钠尿肽水平的研究。

Revista da Associacao Medica Brasileira (1992) Pub Date : 2024-08-16 eCollection Date: 2024-01-01 DOI:10.1590/1806-9282.20240446
Derya Erturk, Meryem Busra Birsen, Durmus Onder, Metin Kaba, Hamit Yasar Ellidag, Zeynep Ozturk Inal
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摘要

研究目的本研究旨在调查足月妊娠中因胎儿窘迫而剖宫产的胎儿的脐动脉 N 末端前脑钠尿肽(NT-proBNP):这项前瞻性病例对照研究在土耳其安塔利亚培训与研究医院产科进行。共纳入 140 名孕妇,其中 70 名在妊娠第 37 至 40 周之间接受了选择性剖宫产手术(第 1 组,对照组),70 名因胎儿窘迫接受了剖宫产手术(第 2 组,研究组)。参与者的社会人口学和产科数据以及胎儿脐血中的 NT-proBNP 水平都被记录在数据库中:结果:两组的年龄、体重指数、胎龄、产前诊断检查、胎儿解剖扫描和婴儿性别比例具有可比性(P>0.05),而在孕周(3.0 vs. 1.0,P≤0.001)和胎次(2 vs. 0,P≤0.001)、婴儿身高(50.36±0.88 vs. 49.80±0.86,P≤0.001)和体重(3422.43±409.16 vs. 3239.86±293.74,p=0.003)、1 分钟 Apgar(9.0±0.1 vs. 8.5±1.3,p≤0.001)和 5 分钟 Apgar(10.0±0.1 vs. 9.8±0.4,p=0.026)评分、脐动脉 pH(7.32±0.05 vs. 7.25±0.07,p≤0.001)、脐动脉基底缺损(-2.48±1.23 vs. -4.36±1.09,p≤0.001)、NT-proBNP水平[8.77(7.72-9.39) vs. 12.35(9.69-12.92),p结论:本研究表明,NT-proBNP 可作为诊断胎儿窘迫的重要标志物。现在需要更多参与者参与的前瞻性研究来证实我们结果的准确性。
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An investigation of the umbilical artery N-terminal proBrain natriuretic peptide levels of fetuses due to fetal distress in term pregnancies.

Objective: This study aimed to investigate umbilical artery N-terminal proBrain natriuretic peptide (NT-proBNP) in fetuses delivered by cesarean section due to fetal distress in term pregnancies.

Methods: This prospective case-control study was conducted at the Antalya Training and Research Hospital Obstetric Department, Turkiye. A total of 140 pregnant women, 70 underwent elective cesarean sections between weeks 37 and 40 of gestation (Group 1, the control group) and 70 underwent cesarean sections due to fetal distress (Group 2, the study group), were included. The participants' sociodemographic and obstetric data and fetal umbilical blood NT-proBNP levels were recorded in a database.

Results: Age, body mass index, gestational age, prenatal diagnostic tests, fetal anatomical scanning, and baby gender ratios were comparable between the groups (p>0.05), while statistically significant differences were observed in terms of gravidity (3.0 vs. 1.0, p≤0.001) and parity numbers (2 vs. 0, p≤0.001), baby height (50.36±0.88 vs. 49.80±0.86, p≤0.001) and weight (3422.43±409.16 vs. 3239.86±293.74, p=0.003), 1-min Apgar (9.0±0.1 vs. 8.5±1.3, p≤0.001) and 5-min Apgar (10.0±0.1 vs. 9.8±0.4, p=0.026) scores, umbilical artery pH (7.32±0.05 vs. 7.25±0.07, p≤0.001), umbilical artery base deficit (-2.48±1.23 vs. -4.36±1.09. p≤0.001), and NT-proBNP levels [8.77 (7.72-9.39) vs. 12.35 (9.69-12.92), p<0.001].

Conclusion: This study showed that NT-proBNP can be used as an important marker in the diagnosis of fetal distress. Prospective studies with more participants are now needed to confirm the accuracy of our results.

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