The Study In Maternal Second-trimester Serum Data Of Pre-pregnancy BMI, Screening Markers And OGTT In The Prediction Of Preeclampsia

Background: Preeclampsia is a kind of disease based on hypertension during pregnancy,and associated with proteinuria,edema and other clinical manifestations.In the worldwide,the incidence is 2.3% ~ 7.6%,average of 5%.Preeclampsia has a great harm to female and son,often lead to fetal distress and fetal growth restriction(FGR),placental abruption,premature birth,acute renal failure and a series of poor prognosis,of all the direct cause of maternal death in the third.At present,there is no effective prediction for preeclampsia.Traditional prediction methods such as mean arterial pressure,and turn mid pregnancy test results are not ideal.In recent years,the pathological physiological changes and pregnant women in preeclampsia own glucolipid metabolic abnormalities gradually become the focus of research.About more than 20 kinds of serum markers were trying to predict preeclampsia,but the vast majority of the clinical trials,only a handful of markers is thought to have a certain predictive value.In addition,pregnancy body mass index(BMI)increases also is believed to increase the risk of preeclampsia.Also studies have shown that the insulin resistance syndrome(IRS)is closely related to the occurrence of preeclampsia.Objective:This study selected mid pregnancy serum biomarkers: h CG,AFP,u E3 as a predictor,and joint pre-pregnant BMI and OGTT for joint forecast,investigate the relationship between these factors with the onset of preeclampsia and diagnostic value,provide the basis for clinical predict preeclampsia.Methods:Rretrospectively analyzed pregnant women in our hospital during 2014.12 to 2016.6who suffered preeclampsia.Collect the basic information before childbirth,mid gestation maternal serological prenatal screening and OGTT and other clinical data.Rule out age,primary hypertension,kidney disease and medical problems associated with PE and other risk factors,participants included 177 cases as preeclampsia group.In a ratio of 1:1 randomly selected in normal pregnancy,childbirth in our collected the clinical data,as control group.Use SPSS17.0 statistical analysis,t test to compare the differences between the two sets of data,to diagnose test method to assess the data value for the forecast of PE,selection of high predictive value factors of combined prediction,calculation combined forecasting model of the area under the ROC curve and sensitivity,specific degrees.Results:1.Two groups of pregnant women age difference had no statistical significance(P st130.05);Pregnancy BMI difference was statistically significant(P ? 0.05);h CG,AFP,u E3,0 h-Glu,2 h-1 h-Glu,Glu data difference was statistically significant(P ?0.05).2.Various factors prediction experiment area under the ROC curve(AUC),pre-pregnancy BMI is 0.602,through h CG,AFP was 0.432,0.570 u E3 0 h-Glu was0.647,0.429,the 1 h-Glu,2 h-Glu for 0.626 to 0.684.3.To pre-pregnancy BMI,h CG,2 h-through Glu as factor combined prediction model,the combined forecasting model area under the curve is 0.787,the sensitivity of 68.4and 63.3.Conclusion:Pre-pregnant BMI,mid gestation maternal serum h CG and OGTT test 0h-Glu,1h-Glu2-Glu of preeclampsia has certain predictive value for preeclampsia.Maternal serum AFP,u E3 has no value for prediction.Joint pre-pregnant BMI,mid gestation maternaserum h CG and OGTT test 2 h-Glu can significantly improve the predictive value.