Huang Junfeng, Wang Cuiting, Li Xianxia, Jing Yuqin
Junfeng Huang, Deputy Chief Nurse. Department of Nursing, Maternal and Child Health Hospital of Jinan City, Jinan City 250001, Shandong Province, China.
Cuiting Wang, Bachelor's Degrees. Department of Obstetrical, Maternal and Child Health Hospital of Jinan City, Jinan City 250001, Shandong Province, China.
Pak J Med Sci. 2021;37(6):1590-1594. doi: 10.12669/pjms.37.6-WIT.4844.
To explore the predictive effect of abnormal glucose metabolism and fetal hemodynamic parameters on adverse pregnancy outcome.
One hundred and nine pregnant women with abnormal glucose metabolism during pregnancy from June 2016 to October 2018 were selected and divided into poor prognosis group (34 cases) and good prognosis group (75 cases). The hemodynamic parameters of fetal cerebral artery (MCA), umbilical artery (UA) and uterine artery of pregnancy (UT-A), including peak systolic velocity (s / D), resistance index (RI) and plasticity index (PI), were measured by color Doppler ultrasound. The receiver operating characteristic (ROC) curve of adverse pregnancy outcomes was drawn and the best threshold index was determined.
MCA-PI poor prognosis group, MCA-RI, RI ratio (MCA/UA) are lower than the good prognosis group, Ut-A-PI is higher than the good prognosis group (P<0.05,). ROC curve analysis results show that when the MCA-PI 1.56, the sensitivity of the predicted adverse outcomes of pregnancy, the highest specificity<, was 91.18%, 80.00%, respectively. Logistic regression analysis of risk factors shows poor pregnancy outcomes include: pregnant women, older age, body mass index ≥24.0kg/m2 and a family history of diabetes. Protective factors include exercise during pregnancy, MCA-PI≥1.56, MCA-RI≥0.63 and RI The ratio (MCA/UA) ≥0.84.
Color Doppler ultrasound measured MCA-PI<1.56 the most important indicators of poor pregnancy outcomes as abnormal glucose metabolism during pregnancy and predict the exact cutoff. Pregnant women, older age, body mass index ≥24.0kg/m2 and a family history of diabetes and abnormal glucose metabolism during pregnancy risk factors for adverse outcomes of pregnancy.
探讨糖代谢异常及胎儿血流动力学参数对不良妊娠结局的预测作用。
选取2016年6月至2018年10月期间孕期糖代谢异常的109例孕妇,分为预后不良组(34例)和预后良好组(75例)。采用彩色多普勒超声测量胎儿脑动脉(MCA)、脐动脉(UA)及妊娠子宫动脉(UT-A)的血流动力学参数,包括收缩期峰值流速(s/D)、阻力指数(RI)及搏动指数(PI)。绘制不良妊娠结局的受试者操作特征(ROC)曲线并确定最佳阈值指标。
预后不良组的MCA-PI、MCA-RI、RI比值(MCA/UA)低于预后良好组,Ut-A-PI高于预后良好组(P<0.05)。ROC曲线分析结果显示,当MCA-PI为1.56时,预测妊娠不良结局的灵敏度最高,分别为91.18%、80.00%。不良妊娠结局危险因素的Logistic回归分析显示,包括孕妇年龄较大、体重指数≥24.0kg/m2及糖尿病家族史。保护因素包括孕期运动、MCA-PI≥1.56、MCA-RI≥0.63及RI比值(MCA/UA)≥0.84。
彩色多普勒超声测量的MCA-PI<1.56是孕期糖代谢异常妊娠结局不良的最重要指标,并预测了确切的截断值。孕妇年龄较大、体重指数≥24.0kg/m2及糖尿病家族史以及孕期糖代谢异常是妊娠不良结局的危险因素。