目的 通过分析歙县1 036名孕中期妊娠妇女产筛资料,了解胎儿发病风险,为预防出生缺陷提供科学依据。方法 采用化学发光免疫分析法检测孕中期妊娠妇女血清β-人绒毛膜促性腺激素(β-HCG)、甲胎蛋白(AFP)和游离雌三醇(uE3)水平,结合孕妇年龄、体重、孕周等数据进行分析,计算胎儿发病风险率。结果 筛查的1 036名孕妇中,高风险61例,占5.8%;临界风险组43例,占4.2%;低风险932例,占90.0%。随访1 010名孕妇的妊娠结局,治疗性引产9例,不同风险组孕妇治疗性引产比例差异有统计学意义(χ²=9.984,P=0.006)。孕妇合并妊娠期高血压疾病32例,其中临界风险组和高风险组妊娠期高血压的检出率高于低风险组(χ²=5.432,P=0.045)。结论 孕中期血清学筛查对预防出生缺陷具有重要作用。

Objective The screening information of 1 036 women in the second trimester of pregnancy in Shexian County were analyzed to understand the risk of fetal morbidity and to provide scientific basis for the prevention of birth defects. Methods Serum β- human chorionic gonadotropin (β-HCG),alpha fetoprotein (AFP) and free estriol (uE3) levels in mid-pregnancy women were detected by chemiluminescence immunoassay.These indicators calculated the risk rate of fetal morbidity by combining maternal age,weight,and gestational weeks. Results Of the 1 036 pregnant women screened,there were 61 cases (5.8%) in the high-risk group,43 cases (4.2%) in the borderline risk group,and 932 cases (90.0%) in the low-risk group.The pregnancy outcomes of 1 010 pregnant women were followed up,with 9 cases of therapeutic induced of labor.The differences of the therapeutic induced labor rates in different risk groups were statistically significance (χ²=9.984,P=0.006).There were 32 cases of combined gestational hypertension in pregnant women.Notably,the detection rate of hypertension in pregnancy was higher in the borderline risk and high risk groups than in the low risk group (χ²=5.432,P=0.045). Conclusion Serological screening in the second trimester of pregnancy has significant effect on the prevention of birth defects.