早期妊娠貧血與母血唐氏症篩檢偽陽性率之關聯

Maternal anemia and the false positive rate of maternal serum screening for Down syndrome

林靜儀(Ching-Yi Lin)

指導教授 ： 曾麗慧

國立臺灣大學/醫學院/分子醫學研究所/碩士(2005年)

https://doi.org/10.6342/NTU.2005.01054

摘要

研究目的: 討論懷孕婦女貧血是否影響妊娠中期母血唐氏症篩檢結果。
研究對象及方法:以中山醫學大學附設醫院產前門診作描述型研究，收集自2001年9月至2004年12月完整產前檢查及母血唐氏症篩檢結果之單胞懷孕婦女。以妊娠初期產前檢查結果區分成貧血及未貧血婦女，比較組間妊娠中期母血唐氏症篩檢之血清中free β-hCG及α-fetoprotein之 multiples of the median values (MoM值)。同時比較組間母血唐氏症篩檢偽陽性率之差別。
研究結果: 研究納入948名含有完整檢查及分娩紀錄之單胞懷孕婦女。有107名為貧血, 平均hemoglobin為10.26±0.66 g/dL, 841名非貧血婦女則平均hemoglobin為12.38±0.76 g/dL. 有43名婦女的唐氏症篩檢結果陽性(懷唐氏症胎兒機率大於1/270)，胎兒染色體經分析均為正常；母血唐氏症篩檢偽陽性率為4.54%。貧血婦女的母血篩檢偽陽性率為5.61%而非貧血婦女的母血篩檢偽陽性率為4.40%，Odds ratio 1.26 (95%CI 0.53 to 3.13, p>0.05)，二組間沒有顯著差異。
結論: 此研究顯示母血唐氏症篩檢在貧血婦女相較於未貧血者並未發現顯著差異的偽陽性率。貧血並不影響妊娠中期母血唐症篩檢。

關鍵字

貧血 ； 唐氏症 ； 染色體異常 ； 產前篩檢 ； 甲型胎兒蛋白 ； 人類絨毛膜激素

並列摘要

Objectives: The aim of this study is to examine the relation between maternal anemia and the results of second trimester maternal serum screening for Down syndrome.
Subjects and Methods: This descriptive study included singleton pregnant women’s prenatal examination data in Chung-Shan Medical University Hospital Prenatal Care Clinic from September 2001 to December 2004. The second trimester maternal serum free β-human chorionic gonadotropin (hCG) levels and α-fetoprotein levels (MSAFP) multiples of the median (MoM) values in anemia pregnancies group were compared with non-anemia pregnancies group. At the same time, we compared the false-positive rate of maternal serum screening for Down syndrome in anemia pregnancies with non-anemia pregnancies.
Results: Nine hundreds and forty eight of first trimester maternal hemoglobin (Hb) data and second trimester maternal serum screening results were collected from singleton pregnant women. There were 107 of anemia women with the mean hemoglobin concentration 10.26±0.66 g/dL, 841 of non-anemia women with the mean hemoglobin concentration 12.38±0.76 g/dL. There were 43 women with “positive results” (the risk > 1/270) of maternal serum screening for Down syndrome and carried normal karyotypes of the fetus. The false positive rate of maternal serum screening was 4.54% in study subject. The false positive rates were 5.61% and 4.40% in anemia women and non-anemia women, the Odds ratio 1.26 (95%CI 0.53 to 3.13, p>0.05). There was not significant difference between anemia and false positive result of maternal serum screening for Down syndrome.
Conclusion: This present study did not revealed significant elevated false positive rate of second trimester maternal serum screening for Down syndrome in anemia pregnancy detected during first trimester. Anemia does not interfere second trimester maternal serum screening result for Down syndrome.

並列關鍵字

anemia ； Down syndrome ； trisomy 21 ； prenatal screen ； AFP ； hCG

參考文獻

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