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预后营养指数与双胎妊娠子痫前期相关。

The prognostic nutritional index is associated with preeclampsia in twin pregnancies.

作者信息

Han Qing, Zheng Shuisen, Chen Xiaoling, Gao Yuting, Zhang Huale, Lin Na

机构信息

College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.

Department of Obstetrics, Fujian Maternity and Child Health Hospital, Fuzhou, China.

出版信息

BMC Pregnancy Childbirth. 2025 May 14;25(1):568. doi: 10.1186/s12884-025-07669-y.

DOI:10.1186/s12884-025-07669-y
PMID:40369512
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12076915/
Abstract

OBJECTIVE

We aimed to investigate the relationship between the prognostic nutritional index (PNI) during the third trimester and the risk of preeclampsia (PE) in twin pregnancies.

METHOD

A total of 2998 twin pregnancies were enrolled in Fujian Maternal and Child Health Hospital from January 2015 to December 2021, including preeclampsia group (n = 421) and control group (n = 2577). The significance of the characteristic variables in predicting PE in twin pregnancies were calculated using the random forest algorithm (Boruta package) and the correlation between PNI and PE in twin pregnancies was examined in three distinct models using multivariable logistic regression corrected for confounders. Receiver operating characteristics (ROC) curves were used to evaluate the ability for PNI to predict PE in twin pregnancies.

RESULTS

PNI (37.92 ± 3.86 vs. 40.57 ± 3.63, P < 0.001) was significantly lower in the PE group than in the control group. After adjusting for all covariates, the PNI was negatively associated with PE in twin pregnancies (OR = 0.780; 95% CI: 0.753, 0.808). Meanwhile, the higher PNI remained an independent protective factor for PE in twin pregnancies compared to lower PNI (OR, 95% CI: 0.410, 0.438-0.530; 0.144, 0.103-0.201) in sensitivity analysis. ROC curve analysis revealed an area under curve (AUC) of 0.691 for PNI and the cut-off value of PNI was 40.162.

CONCLUSION

PNI was negatively correlated with the risk of PE in twin pregnancies, which may help in risk assessment for twin pregnancies.

CLINICAL TRIAL NUMBER

Not applicable.

摘要

目的

我们旨在研究孕晚期的预后营养指数(PNI)与双胎妊娠先兆子痫(PE)风险之间的关系。

方法

2015年1月至2021年12月期间,共有2998例双胎妊娠纳入福建省妇幼保健院,包括先兆子痫组(n = 421)和对照组(n = 2577)。使用随机森林算法(Boruta软件包)计算特征变量在预测双胎妊娠PE中的意义,并使用校正混杂因素的多变量逻辑回归在三个不同模型中检验双胎妊娠中PNI与PE之间的相关性。采用受试者工作特征(ROC)曲线评估PNI预测双胎妊娠PE的能力。

结果

PE组的PNI(37.92±3.86 vs. 40.57±3.63,P < 0.001)显著低于对照组。在调整所有协变量后,双胎妊娠中PNI与PE呈负相关(OR = 0.780;95%CI:0.753,0.808)。同时,在敏感性分析中,与较低PNI相比,较高的PNI仍然是双胎妊娠中PE的独立保护因素(OR,95%CI:0.410,0.438 - 0.530;0.144,0.103 - 0.201)。ROC曲线分析显示PNI的曲线下面积(AUC)为0.691,PNI的截断值为40.162。

结论

双胎妊娠中PNI与PE风险呈负相关,这可能有助于双胎妊娠的风险评估。

临床试验编号

不适用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db65/12076915/e4d0af58f358/12884_2025_7669_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db65/12076915/8cb7aea95a92/12884_2025_7669_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db65/12076915/3ac47ac6f806/12884_2025_7669_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db65/12076915/f99153f14fb0/12884_2025_7669_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db65/12076915/e4d0af58f358/12884_2025_7669_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db65/12076915/8cb7aea95a92/12884_2025_7669_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db65/12076915/3ac47ac6f806/12884_2025_7669_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db65/12076915/f99153f14fb0/12884_2025_7669_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db65/12076915/e4d0af58f358/12884_2025_7669_Fig4_HTML.jpg

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本文引用的文献

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2
Can maternal inflammatory and nutritional status, evaluated by the hemoglobin, albumin, lymphocyte, and platelet (HALP) score and the prognostic nutritional index (PNI) in the first trimester, predict late-onset fetal growth restriction?孕早期通过血红蛋白、白蛋白、淋巴细胞和血小板(HALP)评分及预后营养指数(PNI)评估的母体炎症和营养状况能否预测晚期胎儿生长受限?
BMC Pregnancy Childbirth. 2024 Oct 1;24(1):620. doi: 10.1186/s12884-024-06811-6.
3
Associations of prognostic nutritional index with risk of all-cause and cardiovascular disease mortalities in persons with gestational diabetes mellitus: A NHANES-based analysis.
基于 NHANES 的分析:预后营养指数与妊娠糖尿病患者全因和心血管疾病死亡率风险的相关性。
Diab Vasc Dis Res. 2024 Sep-Oct;21(5):14791641241284409. doi: 10.1177/14791641241284409.
4
Preeclampsia epidemiology(ies) and pathophysiology(ies).子痫前期的流行病学和病理生理学。
Best Pract Res Clin Obstet Gynaecol. 2024 Jun;94:102480. doi: 10.1016/j.bpobgyn.2024.102480. Epub 2024 Feb 22.
5
The role of first trimester serum inflammatory indexes (NLR, PLR, MLR, SII, SIRI, and PIV) and the β-hCG to PAPP-A ratio in predicting preeclampsia.孕早期血清炎症指标(中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值、单核细胞与淋巴细胞比值、全身免疫炎症指数、系统性免疫炎症反应指数和血小板炎症值)及β-人绒毛膜促性腺激素与妊娠相关血浆蛋白A比值在预测子痫前期中的作用。
J Reprod Immunol. 2024 Mar;162:104190. doi: 10.1016/j.jri.2023.104190. Epub 2023 Dec 30.
6
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