بررسی ارزش تشخیصی اندازه‌گیری حجم متوسط پلاکت مادر در سه ماهه اول و سوم بارداری در پیش‌بینی زایمان زودرس

نوع مقاله : اصیل پژوهشی

نویسندگان

1 استاد گروه زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی ایران، تهران، ایران.

2 رزیدنت گروه زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی ایران، تهران، ایران.

3 دانشجوی پزشکی، دانشکده پزشکی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

چکیده

مقدمه: زایمان زودرس، یکی از مهم‌ترین مشکلات حاملگی است که قسمت عمده مرگ‌و‌میر و موربیدیتی نوزادان را حتی در جوامع پیشرفته سبب می‌شود و با پیش‌بینی آن ممکن است بتوان پیامد بارداری را بهبود بخشید. مطالعه حاضر با هدف بررسی ارزش پیشگویی حجم متوسط پلاکتی طی سه ماهه اول و سوم بارداری برای وقوع زایمان زودرس انجام شد.
روش‌کار: این مطالعه کوهورت آینده‌نگر در سال 1400-1398 بر روی 400 زن باردار 12-9 هفته بارداری در بیمارستان اکبرآبادی تهران صورت گرفت. پس از انتخاب مادران بر اساس معیارهای ورود و خروج، نمونه خون جهت بررسی حجم متوسط پلاکت در سه ماهه اول و سپس مجدداً در سن حاملگی 26-28 هفته اخذ و مادران تا زمان زایمان پیگیری شدند. در پایان، بروز زایمان زودرس تعیین و حجم متوسط پلاکت سه ماهه اول و سوم بارداری در دو گروه زایمان زودرس و گروه با زایمان ترم مورد بررسی و مقایسه قرار گرفت. به منظور تعیین دقت تشخیص منحنی ROC ترسیم و سطح زیر منحنی محاسبه شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته ­ها: از 400 نفر بررسی شده، 365 نفر مطالعه را تمام کرده و مورد ارزیابی نهایی قرار گرفتند که 96 نفر (3/26%) مبتلا به زایمان زودرس بودند. متوسط حجم پلاکت در سه ماهه اول در مادران مبتلا به زایمان زودرس تفاوت معنی‌داری با گروه مادران با حاملگی طبیعی نداشت (09/1±68/9 در مقابل 14/1±57/9، 430/0=p). همچنین متوسط حجم پلاکت در سه ماهه سوم در مادران مبتلا به زایمان زودرس تفاوت معنی‌داری با گروه مادران با حاملگی طبیعی نداشت (12/1±62/9 در مقابل 19/1±46/9، 251/0=p). منحنی ROC جهت تعیین دقت حجم متوسط پلاکتی به‌منظور تشخیص زایمان زودرس استفاده شد که با توجه به سطح زیر منحنی برابر با 5/0، ارزش تشخیصی برای زایمان زودرس نداشت.
نتیجه ­گیری: حجم متوسط پلاکت نمی‌تواند شاخص مناسبی برای پیشگویی زایمان زودرس در نظر گرفته شود.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Evaluation of the value of the first and third-trimester maternal mean platelet volume (MPV) for prediction of preterm labor

نویسندگان [English]

  • Maryam Kashanian 1
  • Maryam Hajaran 2
  • Elahe Sadat Khatami 2
  • Amirhossein Kashanian 3
1 Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.
2 Resident, Department of Obstetrics and Gynecology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.
3 Medical Student, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
چکیده [English]

Introduction: Preterm labor is one of the most important pregnancy problems that cause the majority of infant mortality and morbidity even in advanced societies, and it may be possible to improve the outcome of pregnancy by predicting it. The present study was conducted with aim to evaluate the predictive value of the first and the third trimester maternal mean platelet volume (MPV) for prediction of preterm labor.
Methods: This prospective cohort study was performed in 2019-2021 on 400 pregnant women with a gestational age of 9-12 weeks in Akbarabadi Hospital, Tehran. According to the inclusion and exclusion criteria of the study, blood sample was taken to check the mean volume of platelets in the first trimester and again in the gestational age of 26-28 weeks and the mothers were monitored up to delivery. At the end, the incidence of preterm delivery was determined and the mean volume of platelets (MPV) in the first and third trimesters of pregnancy were investigated and compared in two groups of preterm delivery and term delivery. In order to determine the accuracy, the ROC curve was drawn and the area under the curve was calculated. P<0.05 was considered significant.
Results: Out of 400 studied women, 365 finished the study and were evaluated, and 96 women (26.3%) had preterm labor. MPV of the first trimester did not show significant difference between the two groups of preterm delivery and natural delivery (9.68±1.09 vs 9.57±1.14, p= 0.430). Also, MPV of the third trimester was not significantly different between the two groups of preterm delivery and natural delivery (9.62±1.12 vs 9.46±1.19, p= 0.251). The ROC curve was used to determine the accuracy of mean platelet volume in order to diagnose preterm delivery that considering to the area under the ROC curve as 0.50, it showed no predictive value for preterm labor.
Conclusion: The MPV cannot be considered as a suitable index for prediction of preterm labor.

کلیدواژه‌ها [English]

  • Mean platelet volume (MPV)
  • Pregnancy
  • Preterm labor

مراجع

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مجله زنان، مامایی و نازایی ایران
دوره 27، شماره 5
مرداد 1403
صفحه 1-9

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