Obstetrics and GynecologyObstetrics and GynecologyАкушерство и гинекология0300-90922412-5679Bionika Media33281410.18565/aig.2022.269ReviewsОбзорыReview ArticleFeasibility of predicting fetal growth restriction, by identifying plasma biomarkersВозможность прогнозирования задержки роста плода на основе определения биомаркеров в плазме кровиIzhoykinaEkaterina V.ИжойкинаЕкатерина Владимировна
Russian Federation

Laboratory Assistant, Department of Obstetrics and Gynecology

лаборант кафедры акушерства и гинекологии

katushkabig@mail.ruTrifonovaEkaterina A.ТрифоноваЕкатерина Александровна
Russian Federation

PhD, Senior Researcher, Research Institute of Medical Genetics

к.м.н., с.н.с., НИИ медицинской генетики

ekaterina.trifonova@medgenetics.ruKutsenkoIrina G.КуценкоИрина Георгиевна
Russian Federation

Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology

д.м.н., профессор, заведующая кафедрой акушерства и гинекологии

kutsenko.ig@ssmu.ruStepanovIgor A.СтепановИгорь Ардалионович
Russian Federation

PhD, Chief Physician

к.м.н., главный врач

StepanovIA@opc.tomsk.ruGavrilenkoMaria M.ГавриленкоМария Михайловна
Russian Federation

Ph.D. student, Research Institute of Medical Genetics

аспирант, НИИ медицинской генетики

maria.gavrilenko@medgenetics.ruStepanovVadim A.СтепановВадим Анатольевич
Russian Federation

Academician of RAS, Dr. Bio. Sci., Professor, Director of the Research Institute of Medical Genetics

академик РАН, д.б.н., профессор, директор НИИ медицинской генетики

vadim.stepanov@medgenetics.ruSiberian State Medical University, Ministry of Health of RussiaФГБОУ ВО «Сибирский государственный медицинский университет» Минздрава РоссииI.D. Evtushenko Regional Perinatal CenterОГАУЗ «Областной перинатальный центр имени И.Д. Евтушенко»Tomsk National Research Medical Center, Russian Academy of SciencesФГБНУ «Томский национальный исследовательский медицинский центр Российской академии наук»18042023218241504202315042023Copyright ©; 2023, Bionika MediaCopyright ©; 2023, ООО «Бионика Медиа»2023Bionika MediaООО «Бионика Медиа»https://journals.eco-vector.com/0300-9092/article/view/332814

Fetal growth restriction (FGR) remains one of the important obstetric problems, being a risk factor for antenatal and neonatal mortality and morbidity. The timely prediction of FGR is one of the most important measures in reducing adverse pregnancy outcomes. However, despite numerous studies, practical obstetrics still lacks highly sensitive and specific prognostic biomarkers for this disease.

This paper analyzes open-access modern scientific literature data in the PubMed, Cochrane, and eLibrary databases, which characterize the role of biomarkers in predicting the risk of FGR. Meta-analyses demonstrate that beta-human chorionic gonadotropin, alpha-fetoprotein, free estriol, human chorionic somatomammotropin hormone 1, pappalysin 1, inhibin α-subunit, and placental growth factor are considered the most promising predictive biomarkers for FGR. However, the data obtained by most authors suggest that the use of individual biomarkers has insufficient sensitivity and specificity in stratifying the risk of FGR. The most promising direction in this area is the creation of models for complex multiparametric screening based on the study of maternal risk factors, the levels of biomarkers (both proteomic and molecular genetic ones) in conjunction with ultrasound data.

Conclusion: Thus, studies focused on the search for new biomarkers in order to develop a comprehensive screening program that is of high prognostic value in identifying the risk of FGR are highly relevant and determine personalized patient management tactics in the future.

Задержка роста плода (ЗРП) остается одной из важных проблем акушерства, являясь фактором риска антенатальной и неонатальной смертности и заболеваемости. Своевременное прогнозирование ЗРП – одно из важнейших мероприятий в снижении неблагоприятных исходов беременности. Однако, несмотря на многочисленные исследования, практическое акушерство по-прежнему не имеет высокочувствительных и специфичных прогностических биомаркеров данного заболевания.

В рамках представленной статьи проведен анализ современных литературных данных в базах PubMed, Cochrane, eLibrary, опубликованных в открытом доступе и характеризующих роль биомаркеров в прогнозировании риска развития ЗРП. В качестве наиболее перспективных предиктивных биомаркеров ЗРП, по данным метаанализов, рассматриваются β-хорионический гонадотропин человека (β-HCG), α-фетопротеин (AFP), свободный эстриол (Е3), хорионический соматомаммотропный гормон 1 (CSH), паппализин 1 (РАРР-А), α-субъединица ингибина (Inhibin-А) и плацентарный фактор роста (PIGF). Однако данные, полученные большинством авторов, свидетельствуют о том, что использование отдельных биомаркеров обладает недостаточной чувствительностью и специфичностью в стратификации риска развития ЗРП. Наиболее перспективным направлением в этой области является разработка моделей комплексного мультипараметрического скрининга, основанного на изучении материнских факторов риска, уровней биомаркеров (как протеомных, так и молекулярно-генетических) в совокупности с данными ультразвукового исследования.

Заключение: Таким образом, исследования, сфокусированные на поиске новых биомаркеров с целью разработки комплексной скрининговой программы, обладающей высокой прогностической значимостью в выявлении риска развития ЗРП, являются высокоактуальными и определяют персонифицированную тактику ведения пациентки в будущем.

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