The relationship between U-wave inversion characteristics and adverse pregnancy outcomes in pregnant women with gestational hypertension
Objective To explore the characteristics of U-wave inversion in pregnant women with hypertensive dis-eases during pregnancy and its relationship with adverse pregnancy outcomes.Methods A retrospective study was conducted on 100 pregnant women with pregnancy-induced hypertension from February 2021 to February 2024 in Shanghai First Mater-nity and Infant Hospital,with 54 cases in the mild group and 46 cases in the severe group.Five groups(Q1-Q5)were divided based on U-wave inversion depth.The clinical features were compared,and the association with adverse pregnancy outcomes was analyzed using multivariate logistic regression and restricted cubic spline model.Results The blood pressure during pregnancy,the types of antihypertensive drugs taken and the depth of U-wave inversion in the mild group were significantly lower than those in the severe group,and the Apgar score and birth weight of newborns were significantly higher than those in the severe group.Compared with the group with the lowest U-wave depth(Q1),with the increase of U-wave depth(Q2-Q5),the composition ratio,blood pressure,sFlt-1,LDL-C,TC and TG of hypertensive patients during pregnancy were gradually increased,and the 25(OH)D and HDL-C levels were gradually decreased.Multivariate logistic analysis showed that after ad-justing for 20 confounding factors such as age,BMI and age of onset pregnancy,U-wave inversion depth was an independent risk factor for adverse pregnancy outcomes,and the trend test of quinqule array had statistical significance(P trend＜0.001),and the E value of sensitivity analysis was 2.204.Subgroup analysis showed that 25(OH)D＜39.67 and sFlt-1 ≥3399.65 were sig-nificantly associated with the risk of adverse pregnancy outcomes(Pinteraction=0.035,Pinteraction=0.031).Restricted cubic spline model analysis showed that there was no nonlinear relationship between U-wave inversion depth and the risk of adverse preg-nancy outcomes in mild or severe patients.Compared with mild patients,U-wave depth had higher accuracy(0.875)and Youden index(0.749)in predicting adverse pregnancy outcomes in severe patients.The risk of adverse pregnancy in pregnant women with mild gestational hypertension combined with U-wave inversion is 2.320 times higher than that in pregnant women without U-wave inversion,and the risk of adverse pregnancy in pregnant women with severe gestational hypertension com-bined with U-wave inversion is 2.403 times higher than that in pregnant women without U-wave inversion.Conclusion In pregnant women with hypertensive disorders during pregnancy,low U-wave inversion depth was associated with a reduced risk of adverse pregnancy outcomes,and the association was more pronounced in patients with 25(OH)D＜39.67 ng/mL and sFlt-1 ≥3399.65 pg/mL.
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