Dijagnostička valjanost modela zasnovanog na markerima prvog trimestra trudnoće u predviđanju mase ploda na rođenju
Sažetak
Uvod/Cilj. Danas se smanjena porođajna masa ploda smatra jednim od glavnih uzročnika nastanka kardiovaskularnih oboljenja ili metaboličkog sindroma koji nastupaju kasnije tokom života. Mnoge studije su pokazale jak uticaj abnormalne porođajne mase ploda na kasniji razvoj, međutim, zbog jačeg uticaja na razvoj jedinke, poseban akcenat se stavlja na smanjenu porođajnu masu u odnosu da povišenu. Još uvek ne postoji test koji bi sa visokoprocentnom tačnošću jasno klasifikovao trudnice sa visokim rizikom od rađanja deteta s manjom ili većom porođajnom masom s obzirom na gestacijsko doba. Cilj ovog rada je bio postavljanje modela koji bi mogao upućivati na buduću smanjenu ili prekomernu masu novorođenčeta. Metode. Studijom je bila obuhvaćena 191 trudnica, koje su na osnovu telesne mase novorođenčeta, bile podeljene u tri grupe: grupa 1 (˃ 3 000 g), grupa 2 (3 000–4 000 g), grupa 3 (˃ 4000 g). Za svaku grupu su određene i međusobno upoređene vrednosti biohemijskih markera (plazma proteina A povezanog sa trudnoćom – PAPP-A i slobodne β jedinice humanog horionskog gonadotropina) i ultrasonografskih markera (nuhalna translucencija), kao i njihovih multiplih medijana (MoM). Rezultati. Nađeno je da su vrednosti PAPP-A MoM bile znatno niže u grupama trudnica koje su imale plod sa malom telesnom masom (p = 0,003, p = 0,011). Među ispitivanim grupama je dokazana pozitivna, statistički značajna korelacija između PAPP-A MoM i mase novorođenčeta (rs = 0,221, p = 0,001). Zaključak. Korišćenjem kombinacije biohemijskih parametara, sonografskih i demografskih podataka u screening programu uvećava se šansa za ranu identifikaciju fetusa koji su pod povišenim rizikom od restrikcije u rastu ili povećanog rasta. Takođe, sa porastom vrednosti PAPP-A MoM raste i telesna masa fetusa.
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