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| Diagnostic value of the levels of homocysteine, folate and uE3 of pregnant women for their fetal birth defects and their correlation with the fetal chromosomal abnormalities |
| Yongkang Women and Children's Health Care Hospital, Yongkang, Zhejiang Province, 321300 |
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Abstract Explore the diagnostic value of the levels of homocysteine (Hcy), folic acid (FA) and free estriol (uE3) of pregnant women for their fetal birth defects, and to study their correlation with the fetal chromosomal abnormalities. Methods: The clinical data of the pregnant women who had undergone prenatal examination from January 2021 to December 2023 in the hospital were selected in this study retrospectively. Among them, 82 cases with the fetal structural abnormalities were selected in study group, and 164 cases with normal fetuses were selected in control group. The levels of serum Hcy, FA and uE3 of the women were compared between the two groups. The binary logistic regression model was constructed, and receiver operating characteristic (ROC) curve was used to analyze the values of the levels of serum Hcy, FA and uE3 of the women for diagnosing their fetal birth defects. The correlation between the serum Hcy, FA, uE3 levels of the pregnant women and their fetal chromosomal abnormalities was analyzed. Results: The serum Hcy level (7.27±1.20μmlo/L) of the women in the study group was significantly higher than that (6.26±1.15μmlo/L) of the women in the control group. The levels of the serum FA (27.78±2.61 nmlo/L) and uE3 (1.62±0.27 MoM) of the women in the study group were significantly lower than those (30.77±2.85 nmlo/L and 1.85±0.17 MoM) of the women in the control group (all P<0.05). Binary logistic regression model analysis showed that the calculation formula of the fetal birth defects =0.943Hcy-0.335×FA3.040×uE3+8.039. ROC curve analysis showed that the areas under the curve of the Hcy level, the FA level, the uE3 level and the combination of the Hcy, FA and uE3 levels of the women for diagnosing their fetal birth defects were 0.747, 0.779, 0.862 and 0.878, respectively, the sensitivities of which were 65.2%, 65.2%, 81.1% and 90.2%, respectively, and the specificity of which were 80.5%, 78.1%, 91.5% and 84.5%, respectively. The level of the serum Hcy of the pregnant women with the fetal chromosomal abnormalities was significantly higher than that of the pregnant women without the fetal chromosomal abnormalities, but the levels of serum FA and uE3 of the pregnant women with the fetal chromosomal abnormalities were significantly lower. Spearman analysis showed that the Hcy level of the pregnant women with the fetal structural dysplasia was positively correlated with their fetal chromosomal abnormalities, and the FA and uE3 levels of the pregnant women with the fetal structural dysplasia were negatively correlated with their fetal chromosomal abnormalities (all P<0.05). Conclusion: The combination detections of the serum Hcy, FA and uE3 levels of the pregnant women for diagnosing their fetal birth defects can increase the value. The serum Hcy, FA and uE3 levels of the pregnant women are all correlation with their fetal chromosomal abnormalities.
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