Du Lihua, Wang Bo, Zhang Ming, Bai Jinbo, Xu Xiaoyan, Wang Nana
Department of Obstetrics, No. 215 Hospital of Shaanxi Nuclear Industry No. 52 Weiyang West Road, Qindu District, Xianyang 712000, Shaanxi, China.
Department of Obstetrics VI, Northwest Women's and Children's Hospital Xi'an 710000, Shaanxi, China.
Am J Transl Res. 2024 Nov 15;16(11):6581-6592. doi: 10.62347/NFCD8953. eCollection 2024.
To investigate the predictive value of placental growth factor (PlGF) for adverse pregnancy outcome in twin pregnancies at advanced maternal age.
A retrospective analysis was conducted on 387 women with twin pregnancies who delivered at Northwest Women's and Children's Hospital between March 2020 and March 2024. The women were divided into a favorable outcome group (n = 249) and an adverse outcome group (n = 138) based on their pregnancy outcome. Clinical data and laboratory indicators were compared between the two groups. Logistic regression analysis was used to identify independent risk factors for adverse pregnancy outcome. Receiver Operating Characteristic (ROC) curve analysis was performed to evaluate the predictive value of these independent risk factors. Additionally, the interaction between PlGF and other independent risk factors was analyzed.
Significant differences were observed between the favorable and adverse outcome groups in terms of age, pre-pregnancy Body Mass Index (BMI), mode of conception, gestational hypertension, and gestational diabetes (all P < 0.05). Laboratory indicators revealed that the levels of White Blood Cells (WBC), Neutrophils (Neut), Alpha-Fetoprotein (AFP), Beta Human Chorionic Gonadotropin (β-HCG), and 24-hour urine protein quantification were lower in the favorable outcome group, while the levels of Lymphocytes (Lym) and PlGF were higher (all P < 0.05). Multivariate logistic regression analysis identified mode of conception, Neut, Lym, AFP, β-HCG, 24-hour urine protein quantification, and PlGF as independent risk factors for adverse pregnancy outcome (all P < 0.05). The Area Under the Curve (AUC) for PlGF in predicting adverse pregnancy outcomes was 0.874. Furthermore, an interaction was found between PlGF and adverse pregnancy outcome (P < 0.001) as well as between PlGF and 24-hour urine protein level (P = 0.035).
PlGF has significant clinical value for predicting adverse pregnancy outcome in twin pregnancies among women of advanced maternal age. Its levels are strongly correlated with pregnancy outcome and may serve as an effective tool for early screening and intervention in high-risk pregnancies.
探讨胎盘生长因子（PlGF）对高龄孕妇双胎妊娠不良妊娠结局的预测价值。
对2020年3月至2024年3月在西北妇女儿童医院分娩的387例双胎妊娠妇女进行回顾性分析。根据妊娠结局将这些妇女分为良好结局组（n = 249）和不良结局组（n = 138）。比较两组的临床资料和实验室指标。采用逻辑回归分析确定不良妊娠结局的独立危险因素。进行受试者工作特征（ROC）曲线分析以评估这些独立危险因素的预测价值。此外，分析了PlGF与其他独立危险因素之间的相互作用。
良好结局组和不良结局组在年龄、孕前体重指数（BMI）、受孕方式、妊娠期高血压和妊娠期糖尿病方面存在显著差异（均P < 0.05）。实验室指标显示，良好结局组的白细胞（WBC）、中性粒细胞（Neut）、甲胎蛋白（AFP）、β-人绒毛膜促性腺激素（β-HCG）和24小时尿蛋白定量水平较低，而淋巴细胞（Lym）和PlGF水平较高（均P < 0.05）。多因素逻辑回归分析确定受孕方式、Neut、Lym、AFP、β-HCG、24小时尿蛋白定量和PlGF为不良妊娠结局的独立危险因素（均P < 0.05）。PlGF预测不良妊娠结局的曲线下面积（AUC）为0.874。此外，发现PlGF与不良妊娠结局之间存在相互作用（P < 0.001），PlGF与24小时尿蛋白水平之间也存在相互作用（P = 0.035）。
PlGF对高龄孕妇双胎妊娠不良妊娠结局具有重要的临床预测价值。其水平与妊娠结局密切相关，可作为高危妊娠早期筛查和干预的有效工具。
