불량한 임신 결과 예측을 위한 임신중기 산모 혈청 inhibin-A 측정의 연관성
The association between adverse pregnancy outcomes and the serum inhibin A levels in mid-trimester of gestation
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목적: 임신 15~18주에 시행하는 Quad test에서 inhibin-A 측정 결과와 불량한 임신 결과와의 연관성을 조사하였다. 방법: 2005년 1월부터 2007년 3월까지 본원에서 Quad test를 실시하고 분만한 총 140명의 산모에서 Quad test의 표지자인 Inhibin-A와 불량한 임신 결과로 inhibin-A가 2.0 MoM 이상인 군과 조산과 태아성장부전, 임신성고혈압, 유산, 자궁내태아사 망의 발생 빈도를 조사하여 그 상관관계를 살펴보았다. 결과: 임신성 고혈압 질환과 유산에서 inhibin-A와 hCG가 유의한 상관관계를 보였으며 inhibin-A가 hCG보다 더 연관성이 있 었다. 결론: 임신 15~18주에 비정상적인 inhibin-A결과는 Quad test의 다른 표지자들보다 임신성 고혈압질환 및 유산의 위험성이 높을 수 있다는 것을 시사하였으며, 앞으로 inhibin 아단위 유전자의 발현에 관한 분자 생물학적 접근을 해서 그 관계를 밝혀 inhibin-A가 태반의 산화적 스트레스에 대한 지표가 될 수 있는지에 대한 더 자세한 연구가 필요하리라 생각된다.
Abstract
Objectives: To investigate the association between abnormal inhibin-A level in Quad test during the 15 and 18 weeks of gestation and adverse pregnancy outcomes. Methods: From January 2005 to March 2007, women who delivered their babies at our institute after Quad test in second trimester of gestation (N=140) were enrolled. We measured inhibin-A levels (MoM) and other serum markers of the Quad test. And we analyzed the incidence of adverse pregnancy outcomes such as preterm birth, fetal growth restriction, pregnancy induced hypertension, fetal loss, and intrauterine fetal death. Results: When the pregnancy outcomes are hypertensive disorders and fetal losses, the inhibin-A levels are is more elevated with statistically significance. Inhibin-A and hCG levels are elevated with significantly at hypertensive disorders and fetal losses. But inhibin-A levels are more significantly associated with abnormal pregnancy outcomes than hCG. Conclusions: Measurement of inhibin-A levels may be the most useful among other serum markers of the Quad test in predicting adverse obstetric outcomes.
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