Aneuploid Screening Markers In First Trimester Combine Maternal Characteristics With Hypertensive Disorders Of Pregnancy Correlation Studies Of Diseases

Objective To understand whether pregnancy-associated plasma protein-A(PAPP-A),free human chorionic gonadotrophin beta subunit(free β-hCG)and other first trimester aneuploidy screening markers combined with maternal characteristics are associated with hypertensive diseases of pregnancy(HDP)and have diagnostic value.To provide scientific basis for clinical routine development of aneuploid markers in first trimester to predict HDP.Methods A retrospective cohort study method was used to detect a total of 12121 pregnant women in the exposed group(GH group 476 cases and PE group 184 cases)and non-exposed group(normal blood pressure,11461 pregnant women with normal pregnancy).Single factor comparison of different maternal characteristics between the two cohort groups was performed using Chi-square test or Fisher’s exact test,and P<0.10 was used as the screening criteria for subsequent multivariate logistic regression analysis.Finally,the impact of each variable on HDP was evaluated by multivariate logistic regression analysis of the odds ratio(OR)and 95%confidence interval(95%CI)of relevant variables such as aneuploidy screening markers,maternal characteristics,and pregnancy outcome.Results Compared with non-exposed group,the PAPP-A MoM value of pregnant women in the GH and PE groups was lower(P<0.001),while the levels of free β-hCG MoM and NT MoM were not significantly different between the exposed and non-exposed groups(P>0.05).The results of multivariate logistic regression analysis showed that body mass index(BMI)≥30 kg/m2,25 kg/m2<BMI≤29.9 kg/m2,high maternal mean arterial pressure(MAP)were risk factors for GH(OR=4.398,1.809,1.267).History of scarred uterus,oligohydramnios,premature rupture of fetal membranes and parity≥1 were favorable factors to prevent GH occurrence(OR=0.448,0.545,0.633 and 0.648),and GH increased the rate of cesarean section and decreased the birth of macrosomia(OR:1.516,0.533);BMI≥30 kg/m2 and high MAP were risk factors for promoting the occurrence of PE(OR:3.784,1.310),and history of scarred uterus,oligohydramnios,premature rupture of membranes,high PAPP-A were favorable factors to prevent PE occurrence(OR=0.167,0.175,0.556,and 0.595),and PE increased the incidence of fetal growth retardation and low birth weight infants(OR:3.770,4.235)and increased maternal cesarean section rate(OR:4.427).Conclusion Among aneuploidy screening markers,low PAPP-A had clinical value in predicting HDP compared with the non-exposed groups,while free β-hCG and NT had no diagnostic value in predicting HDP.Among the maternal factors,high BMI,especially BMI≥30 kg/m2 and increased MAP,were risk factors for GH and PE.Pregnant women complicated by PE are prone to fetal growth retardation and low birth weight;PE and GH increase the rate of cesarean section,and the serum marker PAPP-A combined with maternal factors for aneuploidy screening in early pregnancy can effectively improve the prediction of HDP,especially PE,and provide a reference for clinical diagnosis and perinatal management.