关键词:

孕早期, 胎儿生长受限, 三维超声, 微RNA-210, 诊断价值

Abstract:

Objective　To analyze the value of three-dimensional ultrasound combined with the level of microRNA-210 (miR-210) in maternal peripheral blood in the diagnosis of fetal growth restriction (FGR) in the first trimester of pregnancy. Methods　This was a retrospective study. Fifty-two pregnant women with FGR treated in Xi'an International Medical Center Hospital from January 2021 to December 2023 were selected as an FGR group, and 52 healthy pregnant women during the same period were selected as a control group. Both groups were (31.16±4.66) years old and (12.12±0.74) weeks pregnant. Ultrasound examination was performed on both groups. Their peripheral blood was collected to detect the level of miR-210 by qPCR. The correlations between the indicators and FGR were analyzed. The efficacies of three-dimensional ultrasound, the level of miR-210 in peripheral blood, and the combination were analyzed using the receiver operating characteristic curve (ROC). t χ² tests and Pearson correlation analysis were used for the statistical comparisons. Results　The body length, body weight, head circumference, and body mass index (BMI) of the neonates in the FGR group were lower than those in the control group [(48.17±2.04) cm vs. (50.02±1.85) cm, (2.22±0.35) kg vs. (2.98±0.62) kg, (31.75±1.58) cm vs. (33.95±1.52) cm, and (9.57±1.25) kg/m² vs. (11.91±1.17) kg/m²], with statistical differences (all P<0.05). The resistance index (RI) and miR-210 in of the pregnant women the FGR group were higher than those in the control group (0.71±0.28 vs. 0.56±0.24 and 3.24±1.55 vs. 1.43±0.63), while the placental volume (PV), vascularization index (VI), and flow index (VFI) of the women and crown-rump length (CRL) of the neonates were lower [(0.79±0.38) cm³ vs. (1.03±0.42) cm³, (19.20±9.50)% vs. (26.72±9.69)%, (7.72±2.16)% vs. (9.08±2.35)%, and (60.74±11.28) mm vs. (66.93±12.37) mm], with statistical differences (all P<0.05). The correlation analysis showed that miR-210 was negatively correlated with body length, body weight, head circumference, and BMI (r=-0.320, -0.419, -0.379, and -0.402; all P<0.05), while PV, RI, VI, VFI, and CRL were positively correlated with body length, body weight, head circumference, and BMI weakly (all P>0.05). The ROC analysis showed that the sensitivity of the combined diagnosis was 88.5%; the specificity was 88.5%; the area under the curve (AUC) was 0.943; the Youden index was 0.770. Conclusions　Three-dimensional ultrasound combined with the level of miR-210 in maternal peripheral blood has a high diagnostic value for FGR in the first trimester of pregnancy. It can be used as an effective method for screening FGR in the first trimester of pregnancy, which helps to identify high-risk pregnant women in early stage and provides basis for timely intervention.

Key words:

Early pregnancy, Fetal growth restriction, Three-dimensional ultrasound, MicroRNA-210, Diagnostic value