Clinical Value Of The Serum Uric Acid In Addition To The SFlt-1/PLGF For Hypertensive Disorders Of Pregnancy

Objective:To determine if second trimester serum uric acid and s Flt-1/PLGF are reasonable predictors of hypertensive disorders of pregnancy(HDP)or not.Methods:This was a prospective cohort study performed in the obstetric clinic of Cangzhou People’s Hospital.Pregnant women from October 2021 to October2022 at 20-24 weeks were selected.The study collected general information of pregnant women.The peripheral blood of patients was collected and separated to detect the concentrations of UA,s Flt-1 and PLGF in peripheral blood.The enrolled patients were followed-up during pregnancy.According to the pregnancy outcome,the patients were divided into HDP group(166cases),GH group(62 cases),PE group(56 cases),SPE group(48 cases),and normal control group(307 cases).The predictive value of UA combined with s Flt-1/PLGF ratio for HDP disease occurrence and pregnancy outcome was analyzed by SPSS23.0 software.Results:1.Comparison of general data between HDP groups and normal control groupThere were no significant differences in age,pre-pregnancy body mass index,pregnancy times and delivery times between HDP groups and normal control group.2.Comparison of serum UA,s Flt-1 and PLGF levels between HDP groups and normal control groupThe serum UA,s Flt-1 and s Flt-1/PLGF were significantly higher than those control group in HDP patients.The serum PLGF concentration was lower those control group.The serum UA,s Flt-1 and s Flt-1/PLGF in SPE group were significantly higher than those GH group and PE group,and the serum PLGF were significantly lower than those in the GH group and PE group.3.Effect of serum UA and s Flt-1/PLGF on pregnancy outcomeStatistical analysis of pregnancy outcomes showed that the cesarean delivery rate,preterm birth rate and neonatal transfer rate to NICU in the HDP groups were significantly higher than those control group,and the birth weight,gestational week of delivery,Apgar score in HDP groups were significantly lower than those normal control group.Statistical analysis of the effect of serum UA and s Flt-1/PLGF on pregnancy outcome between HDP groups showed that the rate of cesarean delivery,preterm birth rate and neonatal transfer rate to NICU increased with increasing serum UA concentration and s Flt-1/PLGF ratio,and the rate of delivery gestational week,birth weight,Apgar score decreased between HDP groups.4.The prediction value of serum UA,s Flt-1/PLGF alone and combination to HDPThe ROC curve result showed that the AUC of serum UA in GH group was 0.651,the cut-off value was 383μmol/L,the sensitivity and specificity were 32.3% and 93.2% respectively.The AUC of of serum UA in PE group was 0.707,the cut-off value was 405μmol/L,the sensitivity and specificity were 50.0% and 89.9% respectively.The AUC of serum UA in SPE group was 0.837,the cut-off value was 460μmlo/L,the sensitivity and specificity were 70.8% and 81.4% respectively.The AUC of s Flt-1/PLGF in GH group was 0.746,the cut-off value was 54.146,the sensitivity and specificity were55.4% and 86.6%.The AUC of s Flt-1/PLGF in PE group was 0.752,the cut-off value was 66.430,the sensitivity and specificity were 56.6% and91.2%.The AUC of s Flt-1/PLGF in SPE group was 0.846,the cut-off value was 95.256,the sensitivity and specificity were 70.8% and 97.1%.In the combined prediction of both,the AUC was 0.770,the cut-off value was0.714,the sensitivity and specificity were 89.3% and 61.3% for the GH group.The AUC was 0.825,the cut-off value was 0.777,the sensitivity and specificity were 92.5% and 69.6% for the PE group.The AUC was 0.938,the cut-off value was 0.807,the sensitivity and specificity were 94.1% and 80.3%for the SPE group.Conclusions:1.HDP is highly correlated with the increased of UA level and s Flt-1/PLGF ratio,and UA level and s Flt-1/PLGF ratio are positively correlated with the severity of HDP disease.2.The serum UA combined with s Flt-1/PLGF have a good predictive value for the occurrence and development of HDP.