血清同型半胱氨酸和雌激素与不良妊娠结局的相关性分析

Correlation Analysis of Serum Homocysteine and Estrogen with Adverse Pregnancy Outcomes

目的:分析血清同型半胱氨酸(Hcy)和雌激素[雌二醇(E_(2))]水平与不良妊娠结局的相关性。方法:选取2019年10月—2020年1月在湖南省职业病防治院进行孕早期(6~13周)产检的403例孕妇作为研究对象,根据孕妇产后是否发生不良妊娠结局将其分为正常妊娠结局组(n=362)和不良妊娠结局组(n=41)。比较两组产妇临床一般资料、E_(2)和Hcy水平,对Hcy和E_(2)预测不良妊娠结局进行多因素回归分析,探讨Hcy和E_(2)水平与孕妇发生不良妊娠结局的相关性。结果:两组孕妇年龄、平均孕周、分娩类型、孕前体重指数、初潮年龄、月经周期、居住地、教育程度、妊娠期糖尿病及妊娠期高血压比较,差异无统计学意义(P>0.05)。正常妊娠结局组E_(2)水平高于不良妊娠结局组,Hcy水平低于不良妊娠结局组,差异有统计学意义(P<0.05)。E_(2)表达水平降低和Hcy表达水平升高是孕妇不良妊娠结局发生的危险因素。E_(2)表达水平与不良妊娠结局的发生呈负相关,Hcy表达水平与不良妊娠结局的发生呈正相关,差异有统计学意义(P=0.000)。结论:孕妇Hcy和E_(2)表达水平与不良妊娠结局的发生具有较高的相关性,通过检测孕妇Hcy和E_(2)表达水平有助于预测不良妊娠结局的发生风险。

Objective:To analyze the correlation of serum homocysteine(Hcy)and estrogen[estradiol(E_(2))]levels with adverse pregnancy outcomes.Methods:From October 2019 to January 2020,403 pregnant women who underwent early pregnancy(6-13 weeks)checkup in Hunan Prevention and Treatment Institute for Occupational Diseases were selected as the study subjects.The pregnant women were divided into normal pregnancy outcome group(n=362)and adverse pregnancy outcome group(n=41)according to whether they had adverse pregnancy outcomes after delivery.The general clinical data of puerpera,and Hcy and E_(2) levels in the two groups were compared.Multivariate regression analysis was performed for Hcy and E_(2) predicting adverse pregnancy outcomes.The correlation of Hcy and E_(2) levels with adverse pregnancy outcomes was investigated.Results:There were no significant differences in maternal age,mean gestational age,type of delivery,body mass index before pregnancy,age at menarche,menstrual cycle,place of residence,education level,gestational diabetes mellitus and gestational hypertension between the two groups(P>0.05).The level of E_(2) in normal pregnancy outcome group was higher than that in adverse pregnancy outcome group,and the level of Hcy in normal pregnancy outcome group was lower than that in adverse pregnancy outcome group,and the difference was statistically significant(P<0.05).Decreased E_(2) expression and elevated Hcy expression were risk factors for adverse pregnancy outcomes in pregnant women.E_(2) expression levels were negatively correlated with the occurrence of adverse pregnancy outcome,and Hcy expression levels were positively correlated with adverse pregnancy outcome,and the difference was statistically significant(P=0.000).Conclusion:The expression levels of Hcy and E_(2) in pregnant women have a high correlation with the occurrence of adverse pregnancy outcomes.Detection of the expression levels of Hcy and E_(2) in pregnant women can help to predict the risk of adverse pregnancy outcomes.