Predictive value of serum MMP-9 and IL-35 on the pregnancy outcome of pregnant women with scar uterus pregnancy
Objective To explore the predictive value of serum matrix metalloproteinase-9(MMP-9)and interleukin-35(IL-35)on the pregnancy outcomes of pregnant women with scar uterus pregnancy.Methods A total of 106 pregnant women with scar uterine pregnancy who visited the First People's Hospital of Wu'an City from October 2020 to March 2022 were collected as the disease group.According to the pregnancy outcome,they were separated into a good group(n=79)and an adverse group(n=27).Normal pregnant women who underwent prenatal examination in our hospital were regarded as the reference group(n=106).ELISA method was applied to measure the expression levels of MMP-9 and IL-35 in serum,multivariate logistic regression was applied to analyze the influencing factors of adverse pregnancy outcomes in pregnant women with scar uterus pregnancy;receiver operating characteristic(ROC)curve was applied to evaluate the predictive value of serum MMP-9 and IL-35 levels for adverse pregnancy outcomes in pregnant women with scar uterus pregnancy.Results The serum MMP-9 expression(367.80±45.51)μg/L level in the disease group was obviously higher than that in the reference group(311.15±42.57)μg/L,while the serum IL-35 expression(301.65±39.69)pg/mL level was obviously lower than that in the reference group(343.28±46.13)pg/mL,the differences were statistically significant(t=9.359,7.043;all P＜0.05);the serum MMP-9 level(425.17±53.28)µg/L in the adverse group were obviously higher than those in the good group(348.19±42.86)pg/L,while the thickness of the lower uterine segment(3.11±0.46)mm and serum IL-35 level(269.75±29.17)pg/mL were obviously lower than those in the good group(4.33±0.75)mm,(312.55±43.28)pg/mL,the differences were statistically significant(t=7.558,7.943,4.774;all P＜0.05);the thickness of the lower uterine segment,serum MMP-9,and IL-35 levels were related factors that affected the occurrence of adverse pregnancy outcomes in pregnant women with scar uterus pregnancy(P＜0.05);the area under the curve(AUC)of serum MMP-9,IL-35,and their combination in predicting adverse pregnancy outcomes in pregnant women with scar uterus pregnancy were 0.902(95％CI:0.829-0.951),0.821(95％CI:0.734-0.888)and 0.963(95％CI:0.907-0.990),respectively;the combination of the two was superior to the independent prediction of serum MMP-9 and IL-35(Zcombination vs.MMP-9=2.331,P=0.020;Zcombination vs.IL-35=3.086,P=0.002).Conclusion The serum levels of MMP-9 and IL-35 in pregnant women with scar uterine pregnancy were obviously increased,and the combination of the two had higher predictive value for adverse pregnancy outcomes in pregnant women with scar uterine pregnancy.
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