摘要
目的探讨孕妇血清叶酸、血浆同型半胱氨酸(Hcy)、维生素A联合筛查对出生缺陷的预测价值。方法选取2018年1月至2020年12月在海南省妇女儿童医学中心分娩出生缺陷患儿的孕妇182例作为出生缺陷组,同时选取分娩正常新生儿的孕妇546例为正常组,比较两组孕妇孕中期的叶酸、Hcy、维生素A水平差异,采用ROC曲线分析叶酸、Hcy、维生素A与出生缺陷的关系。结果出生缺陷组新生儿出生体重为(2.79±0.45)kg,明显低于正常组的(3.30±0.52)kg,差异有统计学意义(t=-11.835,P<0.05)。出生缺陷组孕妇叶酸和维生素A水平分别为(25.59±4.50)nmol/L和(0.41±0.09)mmol/L,明显低于正常组的(31.19±3.38)nmol/L、(0.54±0.10)mmol/L,差异均有统计学意义(t值分别为-17.725、-15.561,P<0.05);出生缺陷组Hcy为(7.63±1.10)μmol/L,明显高于正常组的(6.60±1.03)μmol/L,差异有统计学意义(t=11.484,P<0.05)。叶酸、Hcy、维生素A联合检测预测出生缺陷的ROC曲线下面积(AUC)为0.892,灵敏度为87.00%,特异度为90.00%,优于上述指标单独预测效果。结论叶酸、Hcy、维生素A联合筛查预测新生儿出生缺陷有一定的应用价值。
Objective To explore the predictive value of combined screening of serum folic acid,plasma homocysteine(Hcy)and vitamin A in pregnant women for birth defects.Methods A total of 182 pregnant women who delivered newborns with birth defects in the Hainan Women and Children′s Medical Center from January 2018 to December 2020 were selected as the birth defects group,and 546 pregnant women who delivered normal newborns during the same period were selected as the normal group.The different levels of folic acid,Hcy and vitamin A in the second trimester in pregnant women were compared between the two groups,and the relationships of folic acid,Hcy,vitamin A and birth defects were analyzed with ROC curve.Results The birth weight of newborns in the birth defects group was(2.79±0.45)kg,which was obviously lower than(3.30±0.52)kg in the normal group,and the difference was of statistical significance(t=-11.835,P<0.05).The folic acid and vitamin A of pregnant women in the birth defects group were(25.59±4.50)nmol/L and(0.41±0.09)mmol/L,respectively,which were significantly lower than(31.19±3.38)nmol/L and(0.54±0.10)mmol/L in the normal group,and the differences were statistically significant(t=-17.725 and-15.561,P<0.05).The Hcy in the birth defects group was(7.63±1.10)μmol/L,which was significantly higher than(6.60±1.03)μmol/L in the normal group,and the difference was statistically significant(t=11.484,P<0.05).The area under the ROC curve(AUC)of the combined screening of serum folic acid,Hcy and vitamin A for predicting birth defects was 0.892,with a sensitivity of 87.00%and a specificity of 90.00%,which were better than the predictive effects of above indexes alone.Conclusion Combined screening of serum folic acid,Hcy and vitamin A has a certain application value in predicting neonatal birth defects.
作者
王青慧
杨柳青
冼赛琼
WANG Qinghui;YANG Liuqing;XIAN Saiqiong(Department of Women′s Health Care,Hainan Women and Children′s Medical Center,Hainan Haikou 570206,China)
出处
《中国妇幼健康研究》
2021年第9期1255-1258,共4页
Chinese Journal of Woman and Child Health Research
