Zhang Zhengzheng, Xu Hao, Liu Xiao, Li Pan, Du Wensheng, Han Qiuyu
Department of Obstetrics and Gynecology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002, P.R. China.
Xuzhou Medical University, Xuzhou, Jiangsu 221002, P.R. China.
Exp Ther Med. 2019 Sep;18(3):1761-1767. doi: 10.3892/etm.2019.7724. Epub 2019 Jul 2.
The present study aimed to evaluate changes of pregnancy-associated plasma protein A (PAPP-A) and vascular endothelial growth factor (VEGF) in pregnancy-induced hypertension (PIH). A total of 105 cases (observation group) with complete data that underwent delivery and suffered from PIH in The Affiliated Hospital of Xuzhou Medical University from February 2015 to February 2017 were retrospectively analyzed. The observation group was further divided into the mild observation and severe observation groups according to severity degree of the disease. Another 65 asymptomatic pregnant women were recruited as the healthy control group. Basic data, obstetric data, PAPP-A and VEGF and data of perinatal infants were compared and analyzed. The Logistic regression model was adopted to screen out risk factors for PIH. In the observation group, the rate of periodic antenatal care was lower, and there were more primigravidas and housewives, with lower education level and economic income (P<0.05). In the observation group, the occurrence rates of placental abruption as well as turbid and bloody amniotic fluid were higher than those in the healthy control group (P<0.05). The neonatal birth weight was lower in the observation group than that in the healthy control group, while the occurrence rates of neonatal department transfer, small for gestational age (SGA), neonatal asphyxia and survival rates of perinatal infants were higher (P<0.05). PAPP-A levels at 34-40 gestational weeks in the observation group were significantly higher than those in the healthy control group (P<0.05). VEGF levels were lower than those in the healthy control group (P<0.05). Multivariate analysis revealed that high PAPP-A value [odds ratio (OR)=3.736] and identity of housewife (OR=2.514) were risk factors for PIH, while high VEGF value (OR=5.258), non-primigravid (OR=2.173), higher economic income (OR=4.162) and periodic antenatal care (OR=1.201) were regarded as protective factors. Therefore, enhancement of gestational management, early discovery and early treatment are critical for improving the prognosis of pregnant women and infants.
本研究旨在评估妊娠高血压综合征（PIH）患者血清妊娠相关血浆蛋白A（PAPP-A）及血管内皮生长因子（VEGF）水平变化。回顾性分析2015年2月至2017年2月在徐州医科大学附属医院分娩的105例PIH患者（观察组）的完整资料，并根据病情严重程度将观察组分为轻度和重度组。另选取65例无症状孕妇作为健康对照组，比较分析两组的基本资料、产科情况、PAPP-A及VEGF水平以及围产儿情况。采用Logistic回归模型筛选PIH的危险因素。结果显示，观察组定期产检率低，初产妇及家庭主妇居多，文化程度及经济收入低（P<0.05）。观察组胎盘早剥、羊水浑浊及血性羊水发生率高于健康对照组（P<0.05）。观察组新生儿出生体重低于健康对照组，新生儿转科率、小于胎龄儿（SGA）发生率、新生儿窒息率及围产儿死亡率高于健康对照组（P<0.05）。观察组孕34~40周PAPP-A水平明显高于健康对照组（P<0.05），VEGF水平低于健康对照组（P<0.05）。多因素分析显示，PAPP-A升高[比值比（OR）=3.736]及家庭主妇身份（OR=2.514）为PIH的危险因素，VEGF升高（OR=5.258）、非初产妇（OR=2.173）、经济收入高（OR=4.162）及定期产检（OR=1.201）为PIH的保护因素。因此，加强孕期管理、早发现早治疗对改善母婴预后至关重要。
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