Komplikasyonsuz Gebeliklerde Pregnancy Associated Plasma Protein-A ve Serbest Human Koryonik Gonadotropin Değerlerinin Bebeğin Cinsiyeti, Kilosu ve Boyunu Belirlemedeki Yeri

Yıl 2021, Cilt: 16 Sayı: 3, 388 - 392, 01.11.2021

Filiz Alkan Baylan , Selim Karaküçük

https://doi.org/10.17517/ksutfd.886383

Öz

Amaç: Maternal serumda 0.5-2.5 MoM aralığındaki sß-HCG ve PAPP-A MoM değerlerinin fetal cinsiyet, yenidoğan ağırlığı ve boyunu tahmin etmede etkinliğini değerlendirmek.
Gereç ve Yöntemler: Birinci trimester taraması için anomali taraması yapılan 519 tekil, komplikasyonsuz gebelikte ölçülen tarama testi biyokimyasal bileşenlerinden sß-HCG ve PAPP-A değerleri ile doğum sonu yenidoğanın cinsiyet, boy ve ağırlık verileri retrospektif olarak bulunarak karşılaştırıldı.
Bulgular: sß-HCG MoM değerinin, yenidoğan cinsiyeti ile ilişkili olduğu (U: 29240.5, p: 0.01) ve kız cinsiyete sahip fetüslerde daha yüksek olduğu bulundu. ROC analizinde sß-HCG MoM değerinin kız cinsiyeti tanımada istatistiksel olarak anlamlı (AUC: %56.6, güven aralığı: 0.516-0.615, p: 0.01) olduğu tespit edildi. sß-HCG MoM değerinin, yenidoğan cinsiyetini doğru tahmin etmedeki sensitivitesinin %66.3, spesifitesinin ise %51.9 olduğu (cut off değeri: 0.855 MoM) görüldü. PAPP-A MoM değerinin yeni doğan ağırlığı (r: 0.175, p: <0.001) ve boyu (r: 0.166, p: <0.001) ile pozitif bir korelasyon gösterdiği ve sß-HCG MoM değeri ile yenidoğan boyu arasında çok zayıf bir korelasyon olduğu (r: 0.099, p: <0.005) izlendi.
Sonuç: Çalışmamız birinci trimester tarama testi biyokimyasal belirteçlerinden sß-HCG MoM değerinin fetal cinsiyet ile ilişkili olduğunu göstermiştir. Bu ilişki günümüzde fetal cinsiyeti %100 doğruluk ile tahmin edebilen yöntemler mevcut olduğundan klinik anlamda kullanabilmek için yeterli değildir ancak yine de genetik geçişli bazı hastalıkların değerlendirilmesinde fetal cinsiyet için fikir verebilir. Ayrıca çalışmamızda komplikasyonsuz gebelerde PAPP-A MoM seviyesinin, yenidoğanın boyu ve ağırlığı gibi fetal gelişimi gösteren parametreler ile ilgili bilgi verdiği görülmüştür. Bu ilişkinin fetal gelişimi etkileyen birçok sosyo-demografik etkenin hesaba katıldığı geniş kapsamlı prospektif çalışmalar yapılarak daha da netleşeceği kanaatindeyiz.

Anahtar Kelimeler

PAPP-A, sBHCG, fetal cinsiyet, yenidoğan kilosu

The Role of Pregnancy Associated Plasma Protein-A and Free Human Chorionic Gonadotropin Values in Determining Baby's Gender, Weight and Height in Uncomplicated Pregnancies

Öz

Purpose: To evaluate the effectiveness of sß-HCG and PAPP-A MoM values in the range of 0.5-2.5 MoM in maternal serum in predicting fetal sex, newborn weight and height.
Material and methods: The sß-HCG and PAPP-A values of the screening test biochemical components of 519 single, uncomplicated pregnancies that were screened for anomaly for the first trimester screening were retrospectively compared with the sex, height and weight data of the postpartum newborn.
Results: It was found that sß-HCG MoM value was associated with newborn gender (U: 29240.5, p: 0.01) and was higher in fetuses of female gender. In the ROC analysis, it was found that the sß-HCG MoM value was statistically significant (AUC: 56.6%, confidence interval: 0.516-0.615, p: 0.01) in identifying the female gender. The sensitivity of sß-HCG MoM value in predicting the newborn gender was 66.3% and the specificity was 51.9% (cut off value: 0.855 MoM). PAPP-A MoM value was positively correlated with newborn weight (r: 0.175, p: <0.001) and height (r: 0.166, p: <0.001) and there was a very weak correlation between sß-HCG MoM value and newborn height. (r: 0.099, p: <0.005) were monitored.
Conclusion: Our study showed that sß-HCG MoM value, which is one of the first trimester screening test biochemical markers, is associated with fetal gender. This relationship is not sufficient to be used clinically, as there are methods that can predict fetal sex with 100% accuracy today, but it can still give an idea for fetal sex in the evaluation of some genetic inherited diseases. In addition, in our study, it was observed that the PAPP-A MoM level in uncomplicated pregnant women gave information about parameters showing fetal development such as the height and weight of the newborn. We believe that this relationship will be further clarified by conducting comprehensive prospective studies in which many socio-demographic factors affecting fetal development are taken into account.

Anahtar Kelimeler

PAPP-A, fBHCG, fetal sex, newborn weight

Kaynakça

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