ความสัมพันธ์ของPAPP-A ในช่วงไตรมาสแรกกับสภาวะคลอดก่อนกำหนด

Abstract

Background: Preterm birth is the most common direct cause of neonatal death, especially in developing countries. The rate, in our region, northern part of Thailand, is as high as 15% of live births Additionally, the rates of preterm birth are increasing. All attempts must be made to prevent this serious event. Objective: To determine the strength of relationship between PAPP-A concentrations using Thai-specific reference range, and rates of idiopathic preterm delivery Methods: The records of singleton pregnancies, undergoing first-trimester screening for fetal Down syndrome, between January 2007 and July 2012, were accessed. Serum PAPP-A levels were measured and divided into 2 groups, a group of normal PAPP-A levels (>10th percentile) and a group of low PAPP-A levels (< 10th percentile). The main outcome is the rate of idiopathic preterm births before 37, 34 and 32 weeks of gestation in the two groups Results: The rates of spontaneous preterm birth at <37, <34 and <32 weeks of gestation were significantly higher in women with low PAPP-A levels, (7.6% vs 17.9%, 3.1% vs 11.9%, 2.2% vs 11.9%), with a relative risk of 2.37, 3.79, and 5.41 for preterm birth, respectively (P value < 0.001) Conclusion: In children with asthma and allergic rhinitis attending Allergy Clinic at CMU Hospital, indoor allergen was more important than outdoor allergens in all age groups. Increased sensitization to pollen was observed in the past 10 years. Children with two or more allergic disease had higher chance of sensitization. Sensitization rates and frequency of polysensitization tended to increase with age.