Predictive value of postpartum serum 25-(OH)D,OPN and TGF-β1 levels in primiparous women for postpartum pelvic floor dysfunction
Objective To explore the predictive value of expression levels of postpartum serum 25 hydroxyvitamin D[25-(OH)D],osteopontin(OPN)and transforming growth faction-β1(TGF-β1)in primip-aras with postpartum pelvic floor dysfunction(PFD).Methods 408 primiparas at Hebei North University Af-filiated First Hospital from January 2021 to February 2023 were selected as research subjects.The primiparas were divided into two groups:the PFD group(n=146)and the non-PFD group(n=262)based on the presence of pelvic floor dysfunction.General data between the two groups and serum levels of 25-(OH)D,OPN and TGF-β1 among different POP grades of POP and SUI in the PDF group were compared.The factors influencing the occurrence of postpartum PFD in primiparas and the predictive value of serum 25-(OH)D,OPN and TGF-β 1 levels on postpartum PFD in primiparas were analyzed.Results The age,prenatal BMI,proportions of in-creased body mass during pregnancy(>15 kg),vaginal delivery,neonatal body mass(>3.5kg)prolonged sec-ond stage of labor and serum OPN level in the PFD group were significantly longer or higher than those in the non-PFD group while the levels of serum 25-(OH)D and TGF-β1 were significantly lower than those in the non-PFD group(P<0.05).The expression levels of 25-(OH)D and TGF-β1 were manifested as POP grade Ⅰ>POP grade Ⅱ>POP grade Ⅲ,and SUI grade Ⅰ>SUI grade Ⅱ>SUI grade Ⅲ,while the OPN expression level was shown as POP grade Ⅰ<POP grade Ⅱ<POP grade Ⅲ,and SUI grade Ⅰ<SUI grade Ⅱ<SUI grade Ⅲ(P<0.05).Multivariate logistic regression analysis showed that increased age,increased prenatal BMI,neonatal body mass>3.5 kg,prolonged second stage of labor,and postpartum serum OPN level were risk factors for postpartum PFD in primiparas(P<0.05),and increased postpartum serum 25-(OH)D and TGF-β1 levels were the protective factors(P<0.05).ROC curve analysis revealed that the AUCs of postpartum serum 25-(OH)D,OPN and TGF-β1 and combined diagnosis in predicting postpartum PFD were 0.849,0.857,0.835 and 0.956,respectively,and the combination had a higher diagnostic value.Conclusion The levels of 25-(OH)D,OPN and TGF-β1 in postpartum serum changed with the increase of POP and SUI grades.These indicators had a cer-tain predictive value for postpartum PFD in primiparas.
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