Lancet:早期验血可能揭开流产的秘密

2023-05-18 MedSci原创 MedSci原创 发表于上海

研究结果表明,在流产后不久,即怀孕第五周,从母亲身上采集的血液样本可以确定胎儿是否有染色体异常。

据数据显示,每10名女性中就有一名经历过流产,随着社会和经济的发展,育龄女性妊娠时间越来越晚,在发达国家这个数字甚至更高。虽然流产的原因有据可查,但缺乏循证治疗和预测模型。胎儿非整倍体与下一次成功怀孕的机会有关,而非整倍体的妊娠损失则可能是潜在的母体条件的原因。近期,发表在Lancet杂志的一项研究表明,在流产后不久,即怀孕第五周,从母亲身上采集的血液样本可以确定胎儿是否有染色体异常。

在这项前瞻性队列研究中,作为哥本哈根流产研究(COPL)研究的一部分,研究人员从丹麦公立医院的三个妇科诊所招募了流产女性,年龄超过18岁且在胎龄22 周(即154天)之前流产且经超声证实为宫内妊娠的女性符合纳入条件,妊娠位置不明或葡萄胎妊娠的女性被纳入排除在外。在妊娠组织仍在原位或妊娠组织排出后24小时内收集母体血液,并通过胎儿游离DNA(cffDNA)的全基因组测序进行分析。

研究人员纳入了2020年11月12日和2022年5月1日期间1000名失孕女性。在2020年11月12日至2021年8月14日之间招募的首批333名失孕女性用来评估基于cffDNA测试的有效性,其他667名女性的结果被纳入评估cffDNA的表现。胎儿的胎龄在35~149天之间。与妊娠组织的直接测序相比,基于cffDNA的测试对非整倍体检测的敏感性为85%,特异性为93%。在1000个基于cffDNA的检测结果中,446个为整倍体,405个为非整倍体,37个有多重非整倍体,112个结果不确定。333名女性中有105名没有收到集妊娠组织,或收集了被归类为未知组织的样本。

流产往往不被公开讨论,而当它被讨论时,反应可能是尴尬的。每个人都说'这是正常的',但这并不意味着它正常,或对发生在自己身上的人来说更多或更少的悲伤,这种禁忌也会使一对夫妇更难得到适当的治疗。这种基于cffDNA的测试显示了该方法在区分整倍体和非整倍体流产的潜力和可行性,以改善临床管理,有利于未来的生殖医学和妇女健康研究。

原始出处

Schlaikjær Hartwig T, Ambye L, Gruhn JR, Petersen JF, Wrønding T, Amato L, Chi-Ho Chan A, Ji B, Bro-Jørgensen MH, Werge L, Petersen MMBS, Brinkmann C, Petersen JB, Dunø M, Bache I, Herrgård MJ, Jørgensen FS, Hoffmann ER, Nielsen HS; COPL consortium. Cell-free fetal DNA for genetic evaluation in Copenhagen Pregnancy Loss Study (COPL): a prospective cohort study. Lancet. 2023 Mar 4;401(10378):762-771. doi: 10.1016/S0140-6736(22)02610-1. Epub 2023 Feb 2. PMID: 36739882.

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  1. [GetPortalCommentsPageByObjectIdResponse(id=2137831, encodeId=5e3c213e83136, content=学习了,希望可以得到更多的关注和重视,所谓的正常并非一定是正常, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c3078416159, createdName=好奇心饱饱, createdTime=Fri May 19 09:06:49 CST 2023, time=2023-05-19, status=1, ipAttribution=广东省), GetPortalCommentsPageByObjectIdResponse(id=2137798, encodeId=9bdb213e798db, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2020/02/29/71ea406776c9fce956bd59e02310c78e.jpg, createdBy=a5045290242, createdName=董医生db, createdTime=Fri May 19 06:34:29 CST 2023, time=2023-05-19, status=1, ipAttribution=内蒙古), GetPortalCommentsPageByObjectIdResponse(id=2137796, encodeId=7904213e7963a, content=不错,学习了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=00332233446, createdName=1212ad1cm87暂无昵称, createdTime=Fri May 19 06:18:41 CST 2023, time=2023-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2137760, encodeId=e35f213e760a0, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Thu May 18 23:19:34 CST 2023, time=2023-05-18, status=1, ipAttribution=浙江省), GetPortalCommentsPageByObjectIdResponse(id=2137720, encodeId=512b213e720ab, content=认真学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6EF3hKja8nER8RMzxQdria9eCYFhgLTLsDOeqnvIYdeLDz5eP6EnicLuE5gibiawgno4zUA0jAR7Nbtp2llQ9fs3Mk/0, createdBy=278f1986883, createdName=医鸣惊人, createdTime=Thu May 18 20:10:40 CST 2023, time=2023-05-18, status=1, ipAttribution=山西省)]
    2023-05-19 好奇心饱饱 来自广东省

    学习了,希望可以得到更多的关注和重视,所谓的正常并非一定是正常

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=2137831, encodeId=5e3c213e83136, content=学习了,希望可以得到更多的关注和重视,所谓的正常并非一定是正常, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c3078416159, createdName=好奇心饱饱, createdTime=Fri May 19 09:06:49 CST 2023, time=2023-05-19, status=1, ipAttribution=广东省), GetPortalCommentsPageByObjectIdResponse(id=2137798, encodeId=9bdb213e798db, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2020/02/29/71ea406776c9fce956bd59e02310c78e.jpg, createdBy=a5045290242, createdName=董医生db, createdTime=Fri May 19 06:34:29 CST 2023, time=2023-05-19, status=1, ipAttribution=内蒙古), GetPortalCommentsPageByObjectIdResponse(id=2137796, encodeId=7904213e7963a, content=不错,学习了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=00332233446, createdName=1212ad1cm87暂无昵称, createdTime=Fri May 19 06:18:41 CST 2023, time=2023-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2137760, encodeId=e35f213e760a0, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Thu May 18 23:19:34 CST 2023, time=2023-05-18, status=1, ipAttribution=浙江省), GetPortalCommentsPageByObjectIdResponse(id=2137720, encodeId=512b213e720ab, content=认真学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6EF3hKja8nER8RMzxQdria9eCYFhgLTLsDOeqnvIYdeLDz5eP6EnicLuE5gibiawgno4zUA0jAR7Nbtp2llQ9fs3Mk/0, createdBy=278f1986883, createdName=医鸣惊人, createdTime=Thu May 18 20:10:40 CST 2023, time=2023-05-18, status=1, ipAttribution=山西省)]
    2023-05-19 董医生db 来自内蒙古

    学习了

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=2137831, encodeId=5e3c213e83136, content=学习了,希望可以得到更多的关注和重视,所谓的正常并非一定是正常, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c3078416159, createdName=好奇心饱饱, createdTime=Fri May 19 09:06:49 CST 2023, time=2023-05-19, status=1, ipAttribution=广东省), GetPortalCommentsPageByObjectIdResponse(id=2137798, encodeId=9bdb213e798db, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2020/02/29/71ea406776c9fce956bd59e02310c78e.jpg, createdBy=a5045290242, createdName=董医生db, createdTime=Fri May 19 06:34:29 CST 2023, time=2023-05-19, status=1, ipAttribution=内蒙古), GetPortalCommentsPageByObjectIdResponse(id=2137796, encodeId=7904213e7963a, content=不错,学习了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=00332233446, createdName=1212ad1cm87暂无昵称, createdTime=Fri May 19 06:18:41 CST 2023, time=2023-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2137760, encodeId=e35f213e760a0, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Thu May 18 23:19:34 CST 2023, time=2023-05-18, status=1, ipAttribution=浙江省), GetPortalCommentsPageByObjectIdResponse(id=2137720, encodeId=512b213e720ab, content=认真学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6EF3hKja8nER8RMzxQdria9eCYFhgLTLsDOeqnvIYdeLDz5eP6EnicLuE5gibiawgno4zUA0jAR7Nbtp2llQ9fs3Mk/0, createdBy=278f1986883, createdName=医鸣惊人, createdTime=Thu May 18 20:10:40 CST 2023, time=2023-05-18, status=1, ipAttribution=山西省)]
    2023-05-19 1212ad1cm87暂无昵称

    不错,学习了。

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=2137831, encodeId=5e3c213e83136, content=学习了,希望可以得到更多的关注和重视,所谓的正常并非一定是正常, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c3078416159, createdName=好奇心饱饱, createdTime=Fri May 19 09:06:49 CST 2023, time=2023-05-19, status=1, ipAttribution=广东省), GetPortalCommentsPageByObjectIdResponse(id=2137798, encodeId=9bdb213e798db, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2020/02/29/71ea406776c9fce956bd59e02310c78e.jpg, createdBy=a5045290242, createdName=董医生db, createdTime=Fri May 19 06:34:29 CST 2023, time=2023-05-19, status=1, ipAttribution=内蒙古), GetPortalCommentsPageByObjectIdResponse(id=2137796, encodeId=7904213e7963a, content=不错,学习了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=00332233446, createdName=1212ad1cm87暂无昵称, createdTime=Fri May 19 06:18:41 CST 2023, time=2023-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2137760, encodeId=e35f213e760a0, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Thu May 18 23:19:34 CST 2023, time=2023-05-18, status=1, ipAttribution=浙江省), GetPortalCommentsPageByObjectIdResponse(id=2137720, encodeId=512b213e720ab, content=认真学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6EF3hKja8nER8RMzxQdria9eCYFhgLTLsDOeqnvIYdeLDz5eP6EnicLuE5gibiawgno4zUA0jAR7Nbtp2llQ9fs3Mk/0, createdBy=278f1986883, createdName=医鸣惊人, createdTime=Thu May 18 20:10:40 CST 2023, time=2023-05-18, status=1, ipAttribution=山西省)]
    2023-05-18 1209e435m98(暂无昵称) 来自浙江省

    学习了,谢谢分享

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=2137831, encodeId=5e3c213e83136, content=学习了,希望可以得到更多的关注和重视,所谓的正常并非一定是正常, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c3078416159, createdName=好奇心饱饱, createdTime=Fri May 19 09:06:49 CST 2023, time=2023-05-19, status=1, ipAttribution=广东省), GetPortalCommentsPageByObjectIdResponse(id=2137798, encodeId=9bdb213e798db, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2020/02/29/71ea406776c9fce956bd59e02310c78e.jpg, createdBy=a5045290242, createdName=董医生db, createdTime=Fri May 19 06:34:29 CST 2023, time=2023-05-19, status=1, ipAttribution=内蒙古), GetPortalCommentsPageByObjectIdResponse(id=2137796, encodeId=7904213e7963a, content=不错,学习了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=00332233446, createdName=1212ad1cm87暂无昵称, createdTime=Fri May 19 06:18:41 CST 2023, time=2023-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2137760, encodeId=e35f213e760a0, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Thu May 18 23:19:34 CST 2023, time=2023-05-18, status=1, ipAttribution=浙江省), GetPortalCommentsPageByObjectIdResponse(id=2137720, encodeId=512b213e720ab, content=认真学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6EF3hKja8nER8RMzxQdria9eCYFhgLTLsDOeqnvIYdeLDz5eP6EnicLuE5gibiawgno4zUA0jAR7Nbtp2llQ9fs3Mk/0, createdBy=278f1986883, createdName=医鸣惊人, createdTime=Thu May 18 20:10:40 CST 2023, time=2023-05-18, status=1, ipAttribution=山西省)]
    2023-05-18 医鸣惊人 来自山西省

    认真学习了

    0

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