Patricia Nga Ping Ip , Long Nguyen-Hoang , Piya Chaemsaithong , Jun Guo , Xueqin Wang , Daljit Singh Sahota , Jacqueline Pui Wah Chung , Liona Chiu Yee Poon
{"title":"妊娠 11-13+6 周胎盘超声参数在辅助生殖技术后妊娠并发症预测中的应用","authors":"Patricia Nga Ping Ip , Long Nguyen-Hoang , Piya Chaemsaithong , Jun Guo , Xueqin Wang , Daljit Singh Sahota , Jacqueline Pui Wah Chung , Liona Chiu Yee Poon","doi":"10.1016/j.tjog.2023.09.023","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate the performance of maternal factors, biophysical and biochemical markers at 11–13 + 6 weeks’ gestation in the prediction of gestational diabetes mellitus with or without large for gestational age (GDM ± LGA) fetus and great obstetrical syndromes (GOS) among singleton pregnancy following in-vitro fertilisation (IVF)/embryo transfer (ET).</p></div><div><h3>Materials and methods</h3><p>A prospective cohort study was conducted between December 2017 and January 2020 including patients who underwent IVF/ET. Maternal mean arterial pressure (MAP), ultrasound markers including placental volume, vascularisation index (VI), flow index (FI) and vascularisation flow index (VFI), mean uterine artery pulsatility index (mUtPI) and biochemical markers including placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) were measured at 11–13 + 6 weeks’ gestation. Logistic regression analysis was performed to determine the significant predictors of complications.</p></div><div><h3>Results</h3><p>Among 123 included pregnancies, 38 (30.9%) had GDM ± LGA fetus and 28 (22.8%) had GOS. The median maternal height and body mass index were significantly higher in women with GDM ± LGA fetus. Multivariate logistic regression analysis demonstrated that in the prediction of GDM ± LGA fetus and GOS, there were significant independent contributions from FI MoM (area under curve (AUROC) of 0.610, 95% CI 0.492–0.727; p = 0.062) and MAP MoM (AUROC of 0.645, 95% CI 0.510–0.779; p = 0.026), respectively.</p></div><div><h3>Conclusion</h3><p>FI and MAP are independent predictors for GDM ± LGA fetus and GOS, respectively. However, they have low predictive value. There is a need to identify more specific novel biomarkers in differentiating IVF/ET pregnancies that are at a higher risk of developing complications.</p></div>","PeriodicalId":49449,"journal":{"name":"Taiwanese Journal of Obstetrics & Gynecology","volume":null,"pages":null},"PeriodicalIF":2.0000,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1028455924000743/pdfft?md5=547eec5e97675273fb9182a093230b08&pid=1-s2.0-S1028455924000743-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Ultrasonographic placental parameters at 11–13+6 weeks’ gestation in the prediction of complications in pregnancy after assisted reproductive technology\",\"authors\":\"Patricia Nga Ping Ip , Long Nguyen-Hoang , Piya Chaemsaithong , Jun Guo , Xueqin Wang , Daljit Singh Sahota , Jacqueline Pui Wah Chung , Liona Chiu Yee Poon\",\"doi\":\"10.1016/j.tjog.2023.09.023\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>To evaluate the performance of maternal factors, biophysical and biochemical markers at 11–13 + 6 weeks’ gestation in the prediction of gestational diabetes mellitus with or without large for gestational age (GDM ± LGA) fetus and great obstetrical syndromes (GOS) among singleton pregnancy following in-vitro fertilisation (IVF)/embryo transfer (ET).</p></div><div><h3>Materials and methods</h3><p>A prospective cohort study was conducted between December 2017 and January 2020 including patients who underwent IVF/ET. Maternal mean arterial pressure (MAP), ultrasound markers including placental volume, vascularisation index (VI), flow index (FI) and vascularisation flow index (VFI), mean uterine artery pulsatility index (mUtPI) and biochemical markers including placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) were measured at 11–13 + 6 weeks’ gestation. Logistic regression analysis was performed to determine the significant predictors of complications.</p></div><div><h3>Results</h3><p>Among 123 included pregnancies, 38 (30.9%) had GDM ± LGA fetus and 28 (22.8%) had GOS. The median maternal height and body mass index were significantly higher in women with GDM ± LGA fetus. Multivariate logistic regression analysis demonstrated that in the prediction of GDM ± LGA fetus and GOS, there were significant independent contributions from FI MoM (area under curve (AUROC) of 0.610, 95% CI 0.492–0.727; p = 0.062) and MAP MoM (AUROC of 0.645, 95% CI 0.510–0.779; p = 0.026), respectively.</p></div><div><h3>Conclusion</h3><p>FI and MAP are independent predictors for GDM ± LGA fetus and GOS, respectively. However, they have low predictive value. There is a need to identify more specific novel biomarkers in differentiating IVF/ET pregnancies that are at a higher risk of developing complications.</p></div>\",\"PeriodicalId\":49449,\"journal\":{\"name\":\"Taiwanese Journal of Obstetrics & Gynecology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2024-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S1028455924000743/pdfft?md5=547eec5e97675273fb9182a093230b08&pid=1-s2.0-S1028455924000743-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Taiwanese Journal of Obstetrics & Gynecology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1028455924000743\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Taiwanese Journal of Obstetrics & Gynecology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1028455924000743","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
Ultrasonographic placental parameters at 11–13+6 weeks’ gestation in the prediction of complications in pregnancy after assisted reproductive technology
Objective
To evaluate the performance of maternal factors, biophysical and biochemical markers at 11–13 + 6 weeks’ gestation in the prediction of gestational diabetes mellitus with or without large for gestational age (GDM ± LGA) fetus and great obstetrical syndromes (GOS) among singleton pregnancy following in-vitro fertilisation (IVF)/embryo transfer (ET).
Materials and methods
A prospective cohort study was conducted between December 2017 and January 2020 including patients who underwent IVF/ET. Maternal mean arterial pressure (MAP), ultrasound markers including placental volume, vascularisation index (VI), flow index (FI) and vascularisation flow index (VFI), mean uterine artery pulsatility index (mUtPI) and biochemical markers including placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) were measured at 11–13 + 6 weeks’ gestation. Logistic regression analysis was performed to determine the significant predictors of complications.
Results
Among 123 included pregnancies, 38 (30.9%) had GDM ± LGA fetus and 28 (22.8%) had GOS. The median maternal height and body mass index were significantly higher in women with GDM ± LGA fetus. Multivariate logistic regression analysis demonstrated that in the prediction of GDM ± LGA fetus and GOS, there were significant independent contributions from FI MoM (area under curve (AUROC) of 0.610, 95% CI 0.492–0.727; p = 0.062) and MAP MoM (AUROC of 0.645, 95% CI 0.510–0.779; p = 0.026), respectively.
Conclusion
FI and MAP are independent predictors for GDM ± LGA fetus and GOS, respectively. However, they have low predictive value. There is a need to identify more specific novel biomarkers in differentiating IVF/ET pregnancies that are at a higher risk of developing complications.
期刊介绍:
Taiwanese Journal of Obstetrics and Gynecology is a peer-reviewed journal and open access publishing editorials, reviews, original articles, short communications, case reports, research letters, correspondence and letters to the editor in the field of obstetrics and gynecology.
The aims of the journal are to:
1.Publish cutting-edge, innovative and topical research that addresses screening, diagnosis, management and care in women''s health
2.Deliver evidence-based information
3.Promote the sharing of clinical experience
4.Address women-related health promotion
The journal provides comprehensive coverage of topics in obstetrics & gynecology and women''s health including maternal-fetal medicine, reproductive endocrinology/infertility, and gynecologic oncology. Taiwan Association of Obstetrics and Gynecology.