Correlation Between Serum BNP,LDH Levels And Pre-eclampsia And Adverse Pregnancy Outcomes

Objective:To study the relationship between serum lactate dehydrogenase(LDH)and B-type natriuretic peptide(BNP)levels and pre-eclampsia in pregnant women,and to analyze its predictive value for pre-eclampsia,and to explore the effect of serum LDH and BNP levels on pregnancy outcome.Method:The serum levels of LDH and BNP and other clinical data of 427 pregnant women with hypertensive disorder in Jilin University were analyzed retrospectively.They were divided into gestational hypertension group(127 cases)and pre-eclampsia group(300 cases).The pre-eclampsia group was further divided into the early-onset pre-eclampsia group(130 cases)and the late-onset pre-eclampsia group(170 cases).Quantitative assignments were included in the indicators,and a binary logistic regression model was established for multivariate analysis.BNP levels and LDH levels were quartilely stratified,and the relative risk of pre-eclampsia and its 95% confidence interval were calculated.To explore the relationship between serum BNP and LDH levels and pre-eclampsia and its predictive value for pre-eclampsia and obtain ideal cutoff values.Serum BNP and LDH levels were stratified according to the median,and the effects of serum LDH levels and BNP levels on adverse pregnancy outcomes were preliminarily investigated.Result:(1)Serum BNP levels in patients with hypertensive disorder complicating pregnancy are 140.1(123.8-156.3)pg/ml,and LDH levels are 293.4(278.7-308.2)U/L.The levels of BNP and LDH in the pre-eclampsia group were higher than those in the hypertensive group.The levels of BNP and LDH in the early-onset pre-eclampsia group were higher than those in the late-onset pre-eclampsia group,and the difference was statistically significant(P<0.01).(2)BNP levels and pre-eclampsia risk:To adjust other related risk factors of pre-eclampsia,BNP?54pg/ml as the reference group,the risk of BNP>144pg/ml group was 70 times and 11 times higher than that of the reference group before and after adjustment;LDH level and risk of pre-eclampsia: LDH?198U/L as the reference group,the risk of LDH>289U/L group was 24 times and 6 times higher than that of the reference group before and after adjustment.With the increase of serum BNP and LDH levels,the risk of pre-eclampsia is also increased.There is a quantitative relationship between the two,and the trend test is statistically significant.(3)The relevant indicators were taken into the receiver operating characteristic(ROC)curve analysis,and the serum BNP level,serum LDH level and the combination of the two were used as the analysis indicators.The area under the ROC curve was 0.756,0.728,and 0.792,respectively,both of which were greater than 0.7(P<0.05),all of which have predictive value for the occurrence of pre-eclampsia,and BNP combined with LDH has a greater predictive value for pre-eclampsia.(4)Grouping the LDH and BNP levels according to the median found that in patients with hypertensive disorder complicating pregnancy,the incidence of adverse outcomes in the mothers and fetuses with high serum LDH and BNP levels was significantly higher than in the low-level group.(P <0.01).Conclusion:1.Serum BNP and LDH levels are risk factors for pre-eclampsia,and are important clinical reference indicators for the severity of pre-eclampsia.2.The degree of organ damage in patients with early-onset pre-eclampsia is more serious than that in patients with late-onset pre-eclampsia.Clinical diagnosis and treatment should be given.3.Serum BNP and LDH levels have predictive value for the occurrence of pre-eclampsia,and the combined predictive value of the two is greater.4.The increase of serum BNP and LDH levels is more likely to cause adverse pregnancy outcomes.It should be highly vigilant and concerned in clinical practice to reduce the occurrence of adverse pregnancy outcomes.