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Alamanda Kfoury Pereirahttp://lattes.cnpq.br/8665100317496606Luci Maria S. Dussehttps://wwws.cnpq.br/cvlattesweb/PKG_MENU.menu?f_cod=805037F75C2276C4BC147EF71FA3B3DA#Ludmila Maria Guimarães Pereira2024-02-19T15:32:50Z2024-02-19T15:32:50Z2020-06-24http://hdl.handle.net/1843/64201Objetivo: Avaliar a medida ultrassonográfica do colo uterino e os níveis séricos maternos (colesterol total e frações, triglicérides e arginina dimetil assimétrica), isolados ou em associação, como preditores de parto pré-termo. Métodos: Trata-se de um estudo longitudinal, prospectivo, de correlação entre variáveis bioquímicas e medida ultrassonográfica do colo com a idade gestacional do parto (< ou ≥ 37 semanas). Entre 2015 e 2016, foram avaliadas 145 gestantes portadoras de fatores de risco para parto pré-termo, entre 20 e 24 semanas de gestação, através da medida ultrassonográfica do colo uterino e dos níveis séricos dos biomarcadores. Foram excluídas as gestantes com idade inferior a 18 anos, as que utilizaram progesterona como prevenção de um possível parto prétermo e os casos de prematuridade terapêutica. Este estudo foi aprovado pelo Comitê de Ética e Pesquisa da UFMG (CAAE: 51489715.6.0000.5149). Foi realizada análise de correlação entre os biomarcadores e a medida do colo pelo teste de correlação de Spearman. A curva ROC foi utilizada para determinar a acurácia das variáveis. Foram calculadas sensibilidade e especificidade para a variável que foi considerada preditiva para parto pré-termo, com diferentes pontos de corte. Toda a análise considerou o nível de significância de 0,05, e o software utilizado foi o SPSS versão 20.0. Resultados: Apenas a medida ultrassonográfica do colo apresentou significância estatística como um preditor de parto pré-termo (AUC curva de ROC 0,698 - IC 0,540; 0,856). Colesterol total, HDL, fração não HDL, triglicérides e ADMA apresentaram baixos valores de área sob a curva ROC. Conclusão: A medida ultrassonográfica do colo uterino menor que 2,5 cm entre 20 e 24 semanas de gestação associa-se com a ocorrência de parto pré-termo em gestantes de risco, com especificidade de 98%. Os biomarcadores analisados, isolados ou em associação com a medida do colo, não apresentaram correlação.Objective: To evaluate the measurement of uterine cervix and maternal serum levels of total cholesterol and fractions, triglycerides and asymmetric arginine di-methyl (ADMA), isolated or in association, as predictors of preterm delivery. Methods: This longitudinal, prospective study of correlation among variables and gestational age at birth (<or>=37 weeks) was previously approved by the local Ethics Committee (CAAE:51489715.6.0000.5149). Between 2015 to 2016, 145 pregnant women with risk factors for preterm labor, from 20 to 24 weeks' gestation, were evaluated through the ultrasound measurement of the cervix and serum levels of the biomarkers. Pregnant women younger than 18 years, those who used progesterone as prevention of a possible preterm delivery and cases of therapeutic prematurity were excluded. A correlation analysis was performed among the biomarkers and the cervix measurement by the Spearman correlation test. The ROC Curve was used to determine the accuracy of the variables. Sensitivity and specificity were calculated for the variable that was considered predictive for preterm delivery, with different cut-off points. Statistical analysis was carried employing the SPSS 20.0 and a value of P<0.05 was considered statistically significant. Results: Considering the significance level of 5%, the cervix length show an area under the ROC curve of 0.698 (CI 0.540;0.856). Total cholesterol, HDL, non-HDL, triglycerides and ADMA presented low values of the area under the ROC curve. No significant correlation between these biomarkers and the outcome evaluated (preterm labor) was observed. Conclusion: Only the uterine cervix below 2.5cm, measured by ultrasound, between 20-24 weeks gestation was associated with the occurrence of preterm birth in pregnant women at risk, with specificity of 98%.porUniversidade Federal de Minas GeraisPrograma de Pós-Graduação em Saúde da MulherUFMGBrasilNascimento PrematuroMedição de riscoColo do úteroUltrassonografiaMedida do Comprimento CervicalDissertação AcadêmicaNascimento prematuroMedição de riscoColo do úteroUltrassonografiaMedida do comprimento cervicalMarcadores biológicosCorrelação entre marcadores bioquímicos e medida ultrassonográfica do comprimento do colo uterino na predição do trabalho de parto pré-termoinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMGLICENSElicense.txtlicense.txttext/plain; charset=utf-82118https://repositorio.ufmg.br/bitstream/1843/64201/4/license.txtcda590c95a0b51b4d15f60c9642ca272MD54ORIGINALTese Atualizada Lud repositório.pdfTese Atualizada Lud repositório.pdfapplication/pdf1370802https://repositorio.ufmg.br/bitstream/1843/64201/3/Tese%20Atualizada%20Lud%20reposit%c3%b3rio.pdf3dcbc1c8146bd4e361f64de3fb75880cMD531843/642012024-02-19 12:32:50.447oai:repositorio.ufmg.br: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ório InstitucionalPUBhttps://repositorio.ufmg.br/oaiopendoar:2024-02-19T15:32:50Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)false
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