孕早期肥胖孕妇D-二聚体/纤维蛋白原比值与子痫前期、不良围产结局发生分析

Correlation between the D-dimer/fibrinogen ratio of obese women during the first trimester of pregnancy and their occurrences of preeclampsia and adverse perinatal outcomes

目的:探讨肥胖孕妇孕早期D-二聚体(D-D)/纤维蛋白原(FIB)比值(D/F)与子痫前期发生及围产结局关系。方法:收集2021年1月-2022年1月入住本院妇产科的168例孕早期肥胖孕妇作为观察组,产前检查正常体重孕妇100例为对照组。均检测血清D-D、FIB水平并计算D/F比值。采用受试者工作特性曲线(ROC)确定D/F最佳截断值并分为高表达组、低表达组,分析两组子痫前期及围产结局。结果:孕早期观察组血清D-D(4.58±1.25mg/L)、FIB(3.28±0.97g/L)及D/F(1.40±0.36)均高于对照组(2.20±0.58mg/L、2.59±0.56g/L、0.85±0.11)(均P<0.05)。ROC分析确定D/F最佳截断值为0.95,观察组高表达组(D/F>0.95,73例)、低表达组(D/F≤0.95,95例),高表达组子痫前期发生率(17.8%)高于低表达组(2.1%),早产、胎儿窘迫、新生儿窒息发生率(13.7%、20.6%、4.0%)均高于低表达组(2.1%、5.3%、0)(均P<0.05)。结论:孕早期D/F高表达的肥胖孕妇子痫前期及不良围产结局的发生率更高。

Objective:To explore the correlation between the D dimer/fibrinogen(D/F)ratio of obese pregnant women during the first trimester of pregnancy and their occurrences of preeclampsia and adverse perinatal outcomes.Methods:A total of 168 obese pregnant women were selected in observation group,and 100 pregnant women with normal weight who came to antenatal examination were selected in control group from January 2021 to January 2022.The serum D-di-mer(D-D)and fibrinogen(FIB)levels of the women in the two groups were detected,and the D/F ratio of the women in the two groups was calculated.The optimal cutoff value of the D/F ratio of the women for predicting their occur-rences of preclampsia and adverse perinatal outcomes was determined by rceiver operating characteristic(ROC)curve.According to the cut off value,the women in the observation group were divided group A(women with high D/F ratio)and group B(women with low D/F ratio).The occurrences of preclampsia and adverse perinatal outcomes of the women in group A and group B were analyzed.Results:The levels of serum DD(4.58±1.25mg/L)and FIB(3.28±0.97g/L),and the D/F ratio(1.40±0.36)of the women in the observation group during the first trimester of preg-nancy were significantly higher than those(2.20±0.58mg/L.2.59±0.56g/L.and 0.85±0.11)of the women in the control group(all P<0.05).ROC analysis showed that the optimal cut-off value of D/F was 0.95,and there were 73 women with D/F ratio>0.95 in group A and 95 womcn with D/F ratio≤0.95 in group B.The incidence of preeclamp-sia(17.8%)of the women in group A was significantly higher than that(2.1%)of the women in group B,and the in-cidences of premature birth(13.7%),fetal distress(20.6%),and neonatal asphyxia(4.0%)of the women in group A were significantly higher than those(2.1%,5.3%,and 0)of the women in group B(all P<0.05).Conclusion:The incidences of preclampsia and adverse perinatal outcomes of the obesity pregnant women with high D/F ratio during the first trimester of pregnancy are higher.