新的筛查方法可更好地预测首次妊娠早期子痫前期

A more personalized screening approach for a potentially life-threatening pregnancy complication related to blood pressure could better predict the condition during the first trimester, 当它仍然可以预防的时候, 新的研究表明.

这项研究周一发表在美国心脏协会杂志上 高血压, 展示了一种结合母体病史的筛选算法, ultrasound data and several tests for blood markers could more effectively predict who will develop preeclampsia during their first pregnancy than current risk factor guidelines.

"Preeclampsia is one of the most severe illnesses of pregnancy and may lead to preterm birth and/or maternal death,该研究的资深作者Dr. 伊曼纽尔·布约德在一份声明中说 线上电子游戏飞禽走兽发布会上. He is a professor in the department of obstetrics and gynecology at the Université Laval in Québec City, 加拿大.

"The good news is that we now have a more precise screening approach using existing tests that can predict preeclampsia early in pregnancy,他说. "The next step is to make this screening available to all pregnant women so that more women could receive a diagnosis early in pregnancy" and begin preventive treatment.

Preeclampsia – a dangerous form of high blood pressure that affects 1 in 25 pregnancies in the U.S. -是全世界孕产妇死亡的主要原因. 当血压达到或超过140/90 mmHg时诊断为糖尿病, is more common in first pregnancies and begins developing during the first 12 weeks. 症状通常在第20周之前不会出现. 可能包括头痛, 视力改变，母亲的手肿胀, 脚, 脸或眼睛或婴儿健康状况的变化.

Recent research has linked preeclampsia to an increased risk of developing cardiovascular complications later in life.

Current guidelines from the American College of Obstetricians and Gynecologists encourage pregnant women to take aspirin if they have a major risk factor, 比如慢性高血压, 2型糖尿病, 慢性肾病, 有狼疮或在怀孕前有子痫前期. 有两种中度危险因素的孕妇也建议服用阿司匹林, 比如作为一个黑人女性, 有先兆子痫家族史的, 第一次怀孕, 肥胖或体外受精怀孕.

Prior studies by the Fetal Medicine Foundation have shown that a combination of maternal health history and ultrasound and blood biomarker tests during the first trimester can predict preeclampsia that develops before the 37th week of gestation.

在新的研究中, researchers used the FMF screening model specifically in women who were pregnant for the first time. They wanted to see if they could better predict preterm preeclampsia before the 37th week and early-onset preeclampsia before the 34th in 7,加拿大五个保健中心的325名妇女.

的女人, 他们的平均年龄是29岁，而且大部分是白人, 在研究开始时怀孕11到14周. Preterm preeclampsia developed in 65 women and early-onset preeclampsia occurred in 22.

The new screening model predicted preterm preeclampsia in 63% of cases and early-onset preeclampsia in 77%, 假阳性率为16%. 该算法优于ACOG标准, which would have detected 62% of preterm preeclampsia cases and 59% of early-onset cases, 假阳性率为34%.

一旦子痫前期出现，唯一的解决办法就是分娩. 但这种情况是可以预防的. 在一个 以前的荟萃分析, the researchers found taking low-dose aspirin daily may reduce the risk of preeclampsia by 53%.

The new screening algorithm gives women more information to help them decide whether to take preventive measures, 布约德说.

考虑到他们的个人风险, 女人更容易做出正确的决定,他说. “例如, 如果她选择每天服用小剂量阿司匹林, she is much more likely to follow through because it's based on a personalized screening test."

Dr. Sadiya年代. 汗, a preventive cardiologist at Northwestern Medicine in Chicago who was not involved in the study, said that predicting risk for term and preterm preeclampsia remains an important goal and a priority for improving maternal health and reducing disparities.

"Since the risks for preeclampsia may be largely influenced by health before pregnancy, the ability of a screening model to be applied in early pregnancy is very helpful and can initiate conversations between the clinician and patient about strategies to optimize heart health,汗在线上电子游戏飞禽走兽稿中说. “然而, challenges remain with implementation of models such as this one that integrate biomarkers that are not routinely assessed and may not be widely available, especially among people in vulnerable populations who are most likely to have the highest risk for preterm preeclampsia."