Lu Hsiao-Wen, Hsu Han-Shui
Department of Obstetrics and Gynecology, Cardinal Tien Hospital, New Taipei City, Taiwan.
Institute of Emergency and Critical Care Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Int J Gen Med. 2022 Dec 23;15:8715-8726. doi: 10.2147/IJGM.S392915. eCollection 2022.
This study aimed to use the combination of maternal-obstetrical characteristics (MOCs) and complete blood cell counts (CBCs) with different red blood cell (RBC) indices as an alternative tool to detect preeclampsia (PE) severity immediately before delivery.
This retrospective study included all singleton pregnancies delivered after 24 weeks of gestation from April 2016 to April 2020. Patients were divided into four different groups: non-hypertensive (NH), gestational hypertension (GH), PE, and severe PE (SPE). Univariate and forward stepwise multivariate logistic regression analysis was conducted using MOCs, CBCs, and RBC indices. The calculation was performed between SPE and other non-hypertensive and hypertensive (GH, PE) groups. Moreover, the area under the curve (AUC) for the receiver operating characteristic curve, sensitivity, and specificity were estimated.
The combined variables for differentiating SPE from NH were maternal age >29.5 years, weight >27.24, gestational age <272 days at the time of blood withdrawal, platelet count <217.5×103/μL, Srivastava indices <6.35, and Siradah indices <43.02 (AUC, 0.834; 95% confidence interval [CI], 0.773-0.895). The combined variables for differentiating SPE from GH were maternal age >29.5 years, body mass index >25.28, gestational age <268.5 days at the time of blood withdrawal, mean corpuscular volume <78.85 fL, and platelet count <234.5×103/μL (AUC, 0777; 95% CI, 0.703-0.852). The combined variables for differentiating SPE from PE were maternal age >32.5 years, mean corpuscular hemoglobin concentration >34.55 g/dL, and Siradah indices <40.05 (AUC, 0.745; 95% CI, 0.656-0.833).
The combination of selected variables from MOCs and CBCs with RBC indices before delivery showed satisfactory results for detecting PE severity.
本研究旨在采用孕产妇-产科特征(MOCs)与不同红细胞(RBC)指标的全血细胞计数(CBCs)相结合的方法,作为在分娩前即刻检测子痫前期(PE)严重程度的替代工具。
本回顾性研究纳入了2016年4月至2020年4月期间妊娠24周后分娩的所有单胎妊娠患者。患者被分为四个不同组:非高血压组(NH)、妊娠期高血压组(GH)、子痫前期组(PE)和重度子痫前期组(SPE)。使用MOCs、CBCs和RBC指标进行单因素和向前逐步多因素逻辑回归分析。计算在SPE组与其他非高血压和高血压(GH、PE)组之间进行。此外,还估计了受试者工作特征曲线的曲线下面积(AUC)、敏感性和特异性。
用于区分SPE与NH的联合变量为产妇年龄>29.5岁、体重>27.24、采血时孕周<272天、血小板计数<217.5×10³/μL、Srivastava指数<6.35以及Siradah指数<43.02(AUC,0.834;95%置信区间[CI],0.773 - 0.895)。用于区分SPE与GH的联合变量为产妇年龄>29.5岁、体重指数>25.28、采血时孕周<268.5天、平均红细胞体积<78.85 fL以及血小板计数<234.5×10³/μL(AUC,0.777;95% CI,0.703 - 0.852)。用于区分SPE与PE的联合变量为产妇年龄>32.5岁、平均红细胞血红蛋白浓度>34.55 g/dL以及Siradah指数<40.05(AUC,0.745;95% CI,0.656 - 0.833)。
分娩前从MOCs和CBCs中选择的变量与RBC指标相结合,在检测PE严重程度方面显示出令人满意的结果。