Relationship of uterine arterial pulsatility index, peripheral blood fetal hemoglobin, and placental growth factor level with outcome of early-onset preeclampsia re-pregnancy

doi:10.3877/cma.j.issn.1674-0785.2022.11.013

Abstract

Abstract:

Objective

To explore the relationship of ultrasound uterine arterial pulsatility index (PI), peripheral blood fetal hemoglobin (HbF), and placental growth factor (PIGF) with outcome of early-onset preeclampsia (E-PE) re-pregnancy.

Methods

The clinical data of 81 E-PE pregnant women who had a delivery and were followed at Qinghai Provincial People's Hospital from January 2017 to December 2019 were retrospective analyzed. The patients were (29.23±2.06) years old (25-35 years) and received low-dose aspirin intervention at 13 weeks of gestation. The PI value of the uterine artery as well as the levels of HbF and PIGF in peripheral blood was measured 1 day before treatment. The pregnancy outcome was recorded and the patients were divided into either a poor pregnancy group or a normal group according to the pregnancy outcome. The relationship of PI value of the uterine artery and peripheral blood HbF and PIGF levels with adverse pregnancy outcome was analyzed.

Results

Among the 81 parturients, 19 (23.46%) had adverse pregnancy outcomes. The results of univariate and multivariate logistic regression analysis showed that the decrease of 2-methoxyestradiol (odds ratio [OR]=1.062, 95% confidence interval [CI]: 1.019-1.107), abnormal decrease of PIGF level (OR=95.972, 95%CI: 11.617-792.873), increase of PI value of the uterine artery (OR=1.342, 95%CI: 1.160-1.552), and increase of HbF in peripheral blood (OR=1.210, 95%CI: 1.087-1.347) were factors resulting in adverse pregnancy outcomes in pregnant women with E-PE (P＜0.05 for all). PIGF, PI value of the uterine artery, and abnormal expression of HbF in peripheral blood had significant effects, which might be independent risk factors. Receiver operating characteristic curve analysis showed that the area under the curve of PI value of the uterine artery, peripheral blood HbF, and PIGF in predicting the risk of adverse pregnancy outcome in E-PE pregnant women was 0.852 (95%CI: 0.753-0.951), 0.916 (95%CI: 0.852-0.980), and 0.805 (95%CI: 0.696-0.915), respectively, which had appreciated predictive value.

Conclusion

In patients with E-PE re-pregnancy, increased PI value of the uterine artery, high peripheral blood HbF expression, and low PIGF expression may indicate the risk of adverse pregnancy outcomes.

Key words: Pregnancy, Early preeclampsia re-pregnancy, Uterine arterial pulsatility index, Peripheral fetal hemoglobin, Placental growth factor, Pregnancy outcome

Haihong Song, Ping Li, Xianxia Chen. Relationship of uterine arterial pulsatility index, peripheral blood fetal hemoglobin, and placental growth factor level with outcome of early-onset preeclampsia re-pregnancy[J]. Chinese Journal of Clinicians(Electronic Edition), 2022, 16(11): 1109-1114.

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URL: https://zhlcyszz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-0785.2022.11.013

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References 21

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项目	不良妊娠结局组（n=19）	妊娠结局正常组（n=62）	t值	P值
年龄（岁）	29.10±2.05	29.03±2.01	0.132	0.895
孕前BMI（kg/m²）	22.31±2.07	22.29±2.10	0.036	0.971
分娩时孕周（周）	39.18±0.59	39.20±0.57	0.133	0.895
总胆固醇（mmol/L）	5.28±1.57	5.30±1.54	0.049	0.961
2-ME（ng/L）	534.12±11.89	550.76±12.30	5.198	＜0.001
超声子宫动脉PI	1.72±0.31	1.07±0.28	6.634	＜0.001
外周血HbF（mg/L）	105.46±5.87	82.05±5.36	16.290	＜0.001
PIGF（ng/L）	158.52±6.61	245.33±6.29	53.423	＜0.001

项目	不良妊娠结局组（n=19）	妊娠结局正常组（n=62）	t值	P值
年龄（岁）	29.10±2.05	29.03±2.01	0.132	0.895
孕前BMI（kg/m²）	22.31±2.07	22.29±2.10	0.036	0.971
分娩时孕周（周）	39.18±0.59	39.20±0.57	0.133	0.895
总胆固醇（mmol/L）	5.28±1.57	5.30±1.54	0.049	0.961
2-ME（ng/L）	534.12±11.89	550.76±12.30	5.198	＜0.001
超声子宫动脉PI	1.72±0.31	1.07±0.28	6.634	＜0.001
外周血HbF（mg/L）	105.46±5.87	82.05±5.36	16.290	＜0.001
PIGF（ng/L）	158.52±6.61	245.33±6.29	53.423	＜0.001

变量	B值	标准误	Wald χ²值	OR值（95%CI）	P值
2-ME	0.060	0.021	8.104	1.062（1.019~1.107）	0.004
超声子宫动脉PI	4.564	1.077	17.946	95.972（11.617~792.873）	＜0.001
外周血HbF	0.294	0.074	15.711	1.342（1.160~1.552）	＜0.001
PIGF	0.191	0.055	12.128	1.210（1.087~1.347）	＜0.001

变量	B值	标准误	Wald χ²值	OR值（95%CI）	P值
2-ME	0.060	0.021	8.104	1.062（1.019~1.107）	0.004
超声子宫动脉PI	4.564	1.077	17.946	95.972（11.617~792.873）	＜0.001
外周血HbF	0.294	0.074	15.711	1.342（1.160~1.552）	＜0.001
PIGF	0.191	0.055	12.128	1.210（1.087~1.347）	＜0.001

项目	AUC	95%CI	P值	最佳截断值	灵敏度	特异度	约登指数
超声子宫动脉PI	0.852	0.753~0.951	＜0.001	0.965	0.951	0.500	0.451
外周血HbF	0.916	0.852~0.980	＜0.001	94.495 mg/L	0.947	0.569	0.516
PIGF	0.805	0.696~0.915	＜0.001	172.060 ng/L	0.984	0.840	0.824

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