孕前体质指数及孕早期胎盘生长因子与妊娠期高血压疾病发病及预测分娩结局

Predictive values of the pre pregnancy body mass index and the placental growth factor level of pregnant women with hy-pertensive disorder complicating pregnancy for their delivery outcomes

目的:分析孕前体质指数(BMI)及孕早期血清胎盘生长因子(PLGF)与妊娠期高血压疾病发病关系及对分娩结局的预测价值。方法:回顾性收集2019年1月-2022年4月本院收治的93例妊娠期高血压疾病孕产妇的病历资料作为观察组,同期50例健康妊娠孕产妇为对照组。依据病情严重程度将观察组分为妊娠期高血压组、子痫前期组和重度子痫前期组;收集孕前BMI及孕8~14周血清PLGF水平,采用Pearson相关性分析与妊娠期高血压疾病发病关系,绘制受试者工作特征曲线(ROC)分析2指标预测分娩结局价值。结果:观察组孕前BMI(22.9±1.0 kg/m^(2))高于对照组(20.8±0.9kg/m^(2)),孕早期血清PLGF(36.59±4.38 pg/ml)低于对照组(51.21±4.96 pg/ml),妊娠期高血压组、子痫前期组和重度子痫前期组孕前BMI和早期PLGF水平存在差异(均P<0.05);孕前BMI、孕早期血清PLGF与妊娠期高血压疾病发病分别呈正、负相关性(P<0.05);妊娠期高血压组、子痫前期组和重度子痫前期组患者不良分娩结局总发生率逐渐增加(8.6%、29.0%、55.6%)(P<0.05);孕前BMI、孕早期PLGF及联合预测妊娠期高血压疾病分娩结局的曲线下面积分别为0.836、0.894、0.925,联合预测价值最高。结论:孕前BMI、孕早期血清PLGF与妊娠期高血压疾病发生有关,二者对妊娠期高血压疾病患者分娩结局有较好预测价值。

Objective:To analyze the correlation between the pre-pregnancy body mass index(BMI)value and the pla-cental growth factor(PIGF)level of pregnant women and the occurrence of their hypertensive disorder complicating pregnancy(HDCP),and to study the predictive values of the BMI value and the PIGF level of the women for their de-livery outcomes.Methods:The medical records of 93 pregnant women with HDCP(in observation group)between January 2019 and April 2022 were collected retrospectively,and these women were divided into group A(women with gestational hypertension),group B(women with preeclampsia),and group C(women with severe preeclampsia)ac-cording to the severity of their HDCP.50 healthy pregnant women were selected in control group during the same peri-od.The data of the value of pre-pregnancy BMI and the serum PLGF level during 8-14 gestational weeks of the women were collected.Pearson correlation analysis was used to analyze the correlation between the value of pre-pregnancy BMI and the serum PLGF level of the women and the occurrence of their HDCP.Receiver operating characteristic(ROC)curve was drawn to analyze the values of the value of pre pregnancy BMI and the serum PLGF level for predicting the delivery outcomes of the women.Results:The value of pre-pregnancy BMI(22.9±1.0 kg/m^(2))of the women in the observation group was significantly higher than that(20.8±0.9kg/m^(2))of the women in the control group,the serum PLGF level(36.59±4.38 pg/ml)of the women during the first trimester of pregnancy in the observation group was.significantly lower than that(51.21±4.96 pg/ml)of the women in the control group.There were significant differ-ences in the pre-pregnancy BMI value and the PLGF level of the women during the first trimester of pregnancy among group A,group B,and group C(all P<0.05).The pre-pregnancy BMI value of the women was positively correlated with the occurrence of their HDCP,and the PLGF level of the women during the first trimester of pregnancy was neg-atively correlated with the occurrence of their HDCP(P<0.05).The ovrall incidence of adverse pregnancy outcomes of the women in group A(8.6%),group B(29.0%),and group C(55.6%)had increased gradually(P<0.05).The area under the curve(AUC)of the pre pregnancy BMI value,the PLGF level during the first trimester of pregnancy,and the combined of the pre-pregnancy BMI value and the PLGF level of the women with HDCP for predicting their pregnancy outcomes were 0.836,0.894,and 0.925,respectively,and the AUC of the combined of the pre-pregnancy BMI value and the PLGF level was the highest.Conclusion:There is significant correlation between the pre pregnancy BMI value and the PLGF level during the first trimester of pregnancy of the pregnant women and their occurrence of HDCP.Both the pre pregnancy BMI value and the PLGF level during the first trimester of pregnancy of the pregnant women with HDCP have high predictive value for their delivery outcomes.