The Influnce Of Early-onset Severe Preeclampsia On Neonate And The Relationship Between Disease And Maternal-fetal HLA-DRB1 Gene Polymorphism

Part Ⅰ A study of the effect of early-onset severe preeclampsia on neonatal outcomesObjective To investigate the effect of the puerperants with early-onset severe preeclampsia(sPE)to their newborns by analyzing their clinical materials,improving the cognition of early-onset severe preeclampsia and guide the clinic work.Methods The clinical data of 115 cases as the preeclampsia group(PE group)whose mothers were suffered from sPE and 168 cases as normal control group(NC group)whose mothers have normal pregnancy from November 2016 to November 2017 in the affiliated hospital of Qingdao University was analyzed.The neonatal clinical data were compared between PE group and NC group,and then,the general situation of two groups of newborns(gestational age,body weight,Apgar score)and different age groups(< 30 weeks,30~33+6 weeks and 34~36+6 weeks)adverse prognosis,(Neonatal death,Small Dysplasia,Patent Ductus Arteriosus,Encephalopathy of Prematurity,Retinopathy of Prematurity,and Necrotizing Enterocolitis)were comparative analyzed.Results 1.The maternal age and gravidity of two groups were matching,but the PE group was less than the NC group in gestational age,birth weight and Apgar score at 1 minutes,and the difference was statistically significant(P < 0.05).In addition,the incidence of Small for Gestational Age Infants in the PE group was higher than that in the NC group,among all the gestational age groups of less-than 30 weeks,30~33+6 weeks and 34~36+6 weeks,and the difference was statistically significant(P < 0.05).2.The incidence of Neonatal Respiratory Distress Syndrome and Bronchopulmonary Dysplasia in the PE group was higher than that in the NC group.Furthermore,the ventilator time and the average oxygen consumption time of PE group were longer.All of those differences were statistically significant(P < 0.05).3.There was no significant difference between two groups of neonates in death,Patent Ductus Arteriosus,Encephalopathy of Prematurity,Necrotizing Enterocolitis and Retinopathy of Prematurity(P > 0.05).Conclusions 1.We found that PE especially sPE seriously affected the growth of intrauterine growth,and the incidence of their fetus is much high in intrauterine growth retardation and Small for Gestational Age Infants.2.sPE may delay the fetal lung function maturity,aggravate the lung injury,increase the use rate and use time of the perinatal ventilator.Part Ⅱ The Study between Maternal and Fetal HLA-DRB1 Polymorphism and Genetic Susceptibility of Early-Onset Severe PreeclampsiaObjective The purpose of this study is to investigate the relationship between polymorphisms of maternal-fetal HLA-DRB1 gene,a kind of HLA class II gene,and genetic susceptibility of early-onset severe preeclampsia(sPE)by DNA sequencing of the peripheral blood.Methods The data of newborns 102 as the preeclampsia group(PE group)whose mothers suffered from early-onset severe preeclampsia in the Affiliated Hospital of Qiingdao University during June,2016 to December,2017 was selected;at the same time,the normal term pregnancy of maternal and neonatal 120 as normal control group(NC group)were analysed.The peripheral blood of all those subjects were collected,and the DNA was extracted.he HLA-DRB1 related gene fragments were amplified by real time quantitative polymerase chain reaction(PCR)for direct sequencing.The single nucleotide polymorphisms in the gene fragments were screened,and then these genotype and allele frequency of SNP were analyzed.Results 1.Three polymorphic locus of rs3135388,rs2213586 and rs114293611 were found in HLA-DRB1 related fragments.2.Obviously statistical difference of genotypic was found of rs114293611 in HLA-DRB1 between PE group and NC group(X~2=10.870,P = 0.004).However,no statistical differences were observed in the allele frequency distribution(X~2=0.636,P =0.430,OR =0.854,95%CI=0.579-1.259).3.The genotype and allele frequencies of rs114293611 in HLA-DRB1 between the newborns of two groups were significantly different(Genotype:X~2=16.770,P = 0.000;Allele frequencies:(X~2=10.604,P=0.001,OR =0.521,95%CI=0.351-0.773).4.There is a significant difference in genotype compatibility between the PE group and the NC group after the maternal and infant compatibility of the rs114293611 locus genotypes(X~2=26.122,P = 0.000).5.No statistical differences were observed of rs3135388 and rs2213586 between the PE and the controls in terms of genotypic frequencies,both in patients and newborns,nor for allelic frequencies.Conclusions 1.Our results reveal that the rs114293611 polymorphism of HLA-DRB1 of the maternal and infant may be involved in the development of sPE.2.The abnormal recognition of maternal and infant of rs114293611 in HLA-DRB1 gene may lead to adverse fetal immune tolerance,thus increases risk of preeclampsia.3.We failed to find that rs3135388 and rs2213586 polymorphisms of maternal and infant were associated with the pathogenesis of sPE.