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目的:探讨妊娠中期唐氏综合征产前筛查与孕妇年龄的关系。方法:选择唐山地区门诊自愿接受产前唐氏综合征筛查并住院分娩和接受随访的孕妇5 823例,收集孕妇的体重、年龄、预产期及既往不良孕产史等资料。在妊娠15~21周检测母体血清标志物甲胎蛋白(AFP)、游离雌三醇(uE3)和绒毛膜促性腺激素(β-hCG)水平,利用唐氏综合征专用风险评估软件,结合孕妇体重、年龄、孕周进行风险评估,接受唐氏综合征筛查的孕妇其合并危险度>1/270即视为阳性。将孕妇年龄分为5个组,统计每个组的筛查阳性人数及阳性率,各年龄组之间进行比较。结果:年龄>35岁的孕妇筛查阳性率均显著高于<35岁各年龄组(P<0.05),30~35岁之间孕妇筛查阳性率与>35岁的孕妇筛查阳性率比较无统计学差异。结论:随着孕妇年龄的逐渐增高,唐氏综合征发生的阳性率随之升高,年龄>30岁者发生率明显增高,故建议把30岁以上的孕妇纳入唐氏综合征筛查的高危人群。筛查年龄界定为≥30岁,这样能够提高胎儿唐氏综合征的检出率,降低漏诊率,从而有效地降低唐氏儿的出生率。
Objective: To investigate the relationship between prenatal screening of Down’s syndrome and the age of pregnant women in the second trimester of pregnancy. Methods: A total of 5 823 pregnant women, who were volunteered for screening for prenatal Down Syndrome in Tangshan outpatient department and were hospitalized and followed up, were collected. The pregnant women ’s body weight, age, expected date of birth and previous history of adverse pregnancy were collected. Maternal serum markers of alpha fetoprotein (AFP), free estriol (uE3), and chorionic gonadotropin (beta-hCG) were measured at 15-21 weeks of gestation. Using Down’s syndrome-specific risk assessment software, Weight, age, gestational age for risk assessment, Down’s syndrome screening of pregnant women with a combined risk> 1/270 is considered positive. The pregnant women were divided into five groups, the statistics of each group the positive number of screening and positive rate, compared between the age groups. Results: The screening positive rate of pregnant women aged> 35 years was significantly higher than that of <35 years old (P <0.05). The screening positive rate of pregnant women between 30 ~ 35 years old was higher than that of pregnant women> 35 years old No statistical difference. CONCLUSIONS: With the increasing age of pregnant women, the positive rate of Down Syndrome increases, and the incidence of age> 30 years old is significantly higher. Therefore, pregnant women over 30 years old are suggested to be included in the screening of Down Syndrome crowd. Screening age is defined as ≥ 30 years of age, this can increase the detection rate of fetal Down Syndrome and reduce the rate of misdiagnosis, thereby effectively reducing the birth rate of Down’s children.