Placental Related Diseases Research Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Rama IV Road, Pathumwan, Bangkok, 10330, Thailand.
Sci Rep. 2022 Apr 27;12(1):6886. doi: 10.1038/s41598-022-10861-1.
The objective of this study was to identify the predictive value for preeclampsia of second-trimester serum high mobility group box-1 (HMGB1) and uterine artery Doppler in singleton pregnancies. Between April 2020 and April 2021, a prospective study was conducted on singleton pregnancies with a gestational age of 16-20 weeks at King Chulalongkorn Memorial Hospital, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. Maternal characteristics, uterine artery Doppler, and serum HMGB1 were collected. Serum HMGB1 levels and mean uterine artery pulsatility index (UAPI) were combined to calculate the predictive value for preeclampsia. A total of 393 pregnant women were analyzed, with 25 cases (6.4%) developing preeclampsia and 5 cases (1.3%) developing early-onset preeclampsia. Baseline characteristics of preeclampsia and normal pregnant women were comparable. Preeclamptic pregnant women had significantly higher mean serum HMGB1 levels than normal pregnant women (1112.8 ± 363.1 ng/mL vs 910.8 ± 486.1 ng/mL, p = 0.013). There was no difference in the mean UAPI. Any early-diastolic notching was found more frequently in the preeclampsia group (32.0% vs 12.5%, p = 0.013). The cut-off value for serum HMGB1 levels above 1.04 MoM as abnormal value to predict preeclampsia had sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 88.0%, 53.5%, 11.4% and 98.5%, respectively. When using abnormal serum HMGB1 levels combined with mean UAPI above 95th percentile, the sensitivity, specificity, PPV and NPV to predict preeclampsia were 88.0%, 50.8%, 10.8% and 98.4%, respectively. This study showed that serum HMGB1 at 16-20 weeks of gestation were effective in predicting preeclampsia. The addition of UAPI did not improve the prediction performance.
本研究旨在确定在单胎妊娠中，妊娠中期血清高迁移率族蛋白 B1（HMGB1）和子宫动脉多普勒对先兆子痫的预测价值。2020 年 4 月至 2021 年 4 月，在泰国曼谷朱拉隆功国王纪念医院妇产科进行了一项前瞻性研究，纳入妊娠 16-20 周的单胎妊娠孕妇。收集孕妇的特征、子宫动脉多普勒和血清 HMGB1。结合血清 HMGB1 水平和平均子宫动脉搏动指数（UAPI）计算先兆子痫的预测价值。共分析了 393 例孕妇，其中 25 例（6.4%）发生先兆子痫，5 例（1.3%）发生早发型先兆子痫。先兆子痫孕妇和正常孕妇的基线特征相似。先兆子痫孕妇的平均血清 HMGB1 水平显著高于正常孕妇（1112.8±363.1ng/mL 比 910.8±486.1ng/mL，p=0.013）。两组的平均 UAPI 无差异。先兆子痫组早期舒张期切迹更为常见（32.0%比 12.5%，p=0.013）。血清 HMGB1 水平超过 1.04MoM 的截断值为异常值，预测先兆子痫的敏感度、特异度、阳性预测值（PPV）和阴性预测值（NPV）分别为 88.0%、53.5%、11.4%和 98.5%。当使用异常血清 HMGB1 水平结合 UAPI 超过 95%百分位值时，预测先兆子痫的敏感度、特异度、PPV 和 NPV 分别为 88.0%、50.8%、10.8%和 98.4%。本研究表明，妊娠 16-20 周时的血清 HMGB1 对先兆子痫的预测是有效的，UAPI 的增加并不能提高预测性能。
