摘要
目的 筛选多囊卵巢综合征(PCOS)孕妇发生妊娠期高血压疾病(HDP)的危险因素以及预测指标。方法 选择217例住院分娩的PCOS孕妇临床资料,根据孕20周后是否并发HDP分为HDP组和非HDP组。比较非HDP组与HDP组临床资料;采用Logistic多因素回归分析PCOS孕妇发生HDP的影响因素;采用ROC分析PCOS孕妇发生HDP的预测指标。结果 217例PCOS孕妇中,发生HDP 41例(18.89%)。HDP组HDP家族史、长期被动吸烟史占比、孕前体质指数(BMI)、稳态模型胰岛素抵抗指数(HOMA-IR)高于非HDP组,孕早期血清性激素结合球蛋白(SHBG)、胎盘生长因子(PlGF)、妊娠相关血浆蛋白-A(PAPP-A)水平低于非HDP组(P<0.05)。孕前BMI和孕早期HOMA-IR是PCOS孕妇发生HDP的危险因素,孕早期血清SHBG、PIGF为其保护因素(P<0.05)。孕早期PlGF预测PCOS孕妇发生HDP的灵敏度最高,孕前BMI预测特异度最高。结论 孕前BMI、孕早期血清SHBG、PlGF和HOMA-IR是PCOS孕妇发生HDP的影响因素,其中孕前BMI和孕早期PlGF可作为其预测指标。
Aim To screen the risk factors and predictive indicators of hypertensive disorders of pregnancy(HDP) in pregnant women with polycystic ovary syndrome(PCOS).Methods The clinical data of 217 hospitalized PCOS pregnant women in our hospital were selected,and divided into HDP group and non-HDP group based on whether HDP occurs after 20 weeks of pregnancy.The clinical datas between HDP group and non-HDP group were compared.Influencing factors of PCOS pregnant women with HDP were analyzed by using Logistic multiple regression.The predictor of HDP in pregnant women with PCOS was evaluated by using ROC analysis.Results Among 217 pregnant women with PCOS,41(18.89%) developed HDP.The proportion of HDP family history,long-term passive smoking history,pre-pregnancy body mass index(BMI),and homeostasis model assessment of insulin resistance(HOMA-IR) in the HDP group were higher than those in the non-HDP group.The levels of sex hormone binding globulin(SHBG),placental growth factor(PlGF),and pregnancy-associated plasma protein-A(PAPP-A) in early pregnancy were lower than those in the non-HDP group(P<0.05).Pre-pregnancy BMI and early pregnancy HOMA-IR were risk factors for HDP in PCOS pregnant women,while early pregnancy serum SHBG and PIGF were protective factors(P<0.05).The sensitivity of early pregnancy serum PlGF in predicting HDP in PCOS pregnant women was the highest,while the specificity of pre-pregnancy BMI prediction was the highest.Conclusion Pre-pregnancy BMI,early pregnancy blood SHBG,PlGF,and HOMA-IR are the influencing factors for the occurrence of HDP in PCOS pregnant women,with pre-pregnancy BMI and PlGF serving as predictive indicators.
作者
林彩美
陈钰
王丽佳
LIN Caimei;CHEN Yu;WANG Lijia(Department of Obstetrics,Wuxi Maternal and Child Health Hospital,Wuxi 214000,Jiangsu,China)
出处
《中南医学科学杂志》
CAS
2024年第5期831-834,共4页
Medical Science Journal of Central South China
基金
无锡市卫生健康科研基金项目(FYKY202101)。
