sFlt-1/PLGF,PLGF and PAPP-A in pregnant women with pregnancy-induced hypertension and risk factors for puerperal infection
OBJECTIVE To investigate the soluble vascular endothelial growth factor receptor-1(sFlt-1)/placental growth factor(PLGF),PLGF and pregnancy-related plasma protein-A(PAPP-A)in pregnant women with preg-nancy-induced hypertension(PIH)and their the risk factors for puerperal infection.METHODS A total of 121 pregnant women with pregnancy-induced hypertension with puerperal infection admitted to the Affiliated Hospital of Southwest Medical University and Chongzhou Maternal and Child Health and family Planning Service Center from Mar.2020 to Mar.2023 were selected as the study group,and 121 pregnant women with pregnancy-induced hypertension without puerperal infection during the same period were selected as the control group.According to the pregnancy outcome of pregnancy-induced hypertension patients with puerperal infection,they were divided into a good group(93 cases)and a bad group(28 cases).The distribution of pathogenic bacteria of puerperal infection in pregnant women with pregnancy-induced hypertension was analyzed.The clinical data of the two groups were compared,and the risk factors of puerperal infection in pregnant women with pregnancy-induced hypertension were analyzed.The levels of sFlt-1/PLGF,PLGF and PAPP-A were compared between pregnant women with pu-erperal infection of different pregnancy outcomes.The predictive value of sFlt-1/PLGF,PLGF and PAPP-A on the adverse pregnancy outcome in pregnant women with puerperal infection of pregnancy-induced hypertension was analyzed by receiver operating characteristic(ROC)curve.RESULTS The pathogens of puerperal infection in pregnant women with pregnancy-induced hypertension were predominantly gram-positive bacteria.The risk fac-tors of puerperal infection in pregnant women with pregnancy-induced hypertension were length of labor,postpar-tum hemorrhage,cesarean section,prenatal anemia and premature rupture of membranes(P＜0.05).Plasma sFlt-1/PLGF and serum PAPP-A levels in the poor group were higher than those in the good group(P＜0.05),while plasma PLGF was lower than those in the good group(P＜0.05).The ROC curves showed that the area under the curve(AUC)of sFlt-1/PLGF,PLGF and PAPP-A alone and in combination for the diagnosis of adverse pregnancy outcomes in pregnant women with pregnancy-induced hypertension were 0.775,0.751,0.724 and 0.820,respectively,and that the AUC of the combination was higher than those of the individual assays(P＜0.05),and the sensitivity and specificity of the combined detection were 75.00％and 78.50％,respectively.CONCLUSION The main pathogens of puerperal infection in pregnant women with pregnancy-induced hypertension were gram-positive bacteria.The sFlt-1/PLGF and PAPP-A were highly expressed and PLGF was decreased in patients with pregnancy-induced high pregnancy outcome.Combined detection of sFlt-1/PLGF,PLGF and PAPP-A was helpful for the diagnosis of adverse pregnancy outcomes in pregnant women with puerperal infection.The risk factors of puerperal infection in pregnant women with pregnancy-induced hypertension were length of labor,postpartum hemorrhage,cesarean section,prenatal anemia and premature rupture of membranes.Targeted treat-ment and preventive measures should be given to patients accordingly.
NETL
NSTL
万方数据
