Trend Of Urinary Misfolding Protein In Pregnant Women And Women With Preeclampsia During Gestation

Objective:This study was to analyze the trend of urinary misfolding protein in pregnant women at different gestational weeks,and compare its diagnostic efficacy with conventional urinary protein in women with preeclampsia in order to determine its predictive value and diagnostic value for preeclampsia.Methods:A total of 573 urine samples from pregnant women who received prenatal examination and delivery in the hospital of Shengjing Hospital affiliated to China Medical University from January 2017 to June 2018 were collected.The pregnancy outcome was followed up after 28th weeks of gestation.There were 464 normal pregnant wowen?normal pregnancy group?and 109 patients with preeclampsia?preeclampsia group?.According to the gestation of urine sample collection,it is divided into5-13⁺⁶weeks,14-20⁺⁶weeks,21-24⁺⁶weeks,25-28⁺⁶ weeks,and 29-32⁺⁶ weeks,33-36⁺⁶weeks,37-40 weeks.We tested the urine for the misfolding protein and the conventional urinary protein in each group of pregnant women.Kruskal-Wallis H Test was used to analyze the difference of urinary misfolding protein among different gestational weeks.The sensitivity and specificity of urinary misfolding protein and conventional urinary protein for pre-eclampsia detection were tested by McNemar test.Results:In the preeclampsia group,the level of urinary misfolding protein was higher in the intermediate and late pregnancy than in the normal pregnancy group,and the difference was statistically significant?P<0.01?.It was found that there was no significant difference in urinary misfolding protein in normal pregnancy group between gestation week group?H=8.667,P=0.193>0.05?.In the normal pregnancy group,the level of urinary misfolding protein remained stable at a low level throughout the pregnancy,while in the preeclampsia group,the level of urinary misfolding protein increased with the increase of gestational weeks.The level of urinary misfolding protein in the preeclampsia group was different at each gestational week?H=30.659,P=0.000<0.05?.The specificity?99.35%?and positive prediction?92.11%?of the urinary misfolding protein test during the preeclampsia were higher than the specificity?48.71%?and positive prediction?22.73%?of the conventional urinary protein?P<0.05?,and the pseudo-positive rate of the urinary misfolding protein were low?0.65%?.The accuracy of the prediction of preeclampsia by the protein was much higher?86.56%?than that of the conventional protein?51.66%?.However,the sensitivity?32.11%?of the urinary misfolding protein was lower than that of the conventional urine protein?64.22%??P<0.05?.Conclusion:In normal pregnant women,the level of urinary misfolding protein is maintained at a low level throughout the whole pregnancy,but there is a significant increase in preeclampsia.The difference suggests that the urinary misfolding protein can be used to predict and diagnose the onset of preeclampsia.Moreover,it also has obvious advantages in the specificity and positive predictive value in the diagnosis of preeclampsia compared with conventional urinary protein.And the false positive rete is extremely low.However,it may still needs to be combined with other markers to predict preeclampsia due to its low sensitivity.