Analysis Of The Relationship Between NT-proBNP,RDW And Birth Weight Of Offspring Of CHD Pregnant Women

ObjectiveTo explore the maternal risk factors of small for gestational age(SGA)in offspring of pregnant women with congenital heart disease(CHD),and to provide meaningful indicators for the risk assessment of adverse events in offspring of pregnant women with CHD.MethodsRetrospective analysis was performed on 84 pregnant women with congenital heart disease who were confirmed by MDT consultation and delivered in the Northern Theater General Hospital command from December 2018 to February 2020.The offspring of CHD pregnant women were divided into non-SGA group(72 cases)and SGA group(12 cases)in strict accordance with the diagnostic criteria of SGA and international data published by the 21 st century international fetal and newborn growth association.At the same time,basic data of pregnant women were collected,such as age,BMI,family annual income,cardiac function classification and pregnancy risk classification of heart disease.Laboratory data included n-terminal pro-b-type natriuretic peptide(NT-pro BNP)and Red blood cell distribution width(RDW),blood oxygen saturation(Sp O2),and high-sensitivity c-reactive protein(hs-CRP)were analyzed by taking the highest value of NT-pro BNP,RDW and hs-CRP and the lowest value of Sp O2 in pregnancy test respectively.First,single factor analysis was used to compare the maternal basic data and laboratory examination data between the two groups to determine the maternal factors with statistical significance.Then,these maternal factors were analyzed by multiple factors to determine independent predictors,and the clinical predictive value of independent predictors was analyzed by using receiver operating characteristic curve(ROC).Finally,the correlation between independent predictors and neonatal weight in CHD pregnant women was analyzed.SPSS 25.0 statistical software was used to analysis.All test results were statistically significant with P < 0.05.ResultsOur study showed that the incidence of SGA in offspring of CHD pregnant womenwas 14.3%,and there were no cases of pregnant women and offspring death.Single factor analysis showed that there was no significant difference between SGA group and non SGA group in maternal basic data,such as age,gestational week,BMI,family monthly income,cardiac function grade and pregnancy risk grade of heart disease(P>0.05),and there was no significant difference in NT-pro BNP,RDW and Sp O2(P<0.05).The average value of NT-pro BNP and RDW in SGA group was higher than that in non-SGA group.The average value of Sp O2 in SGA group was lower than that of nonSGA group.There was no significant difference in hs-CRP between the two groups(P>0.05).Multivariate logistic regression analysis showed that NT-pro BNP and RDW were significantly related to SGA(P< 0.05),and were independent predictors of SGA in the offspring of CHD pregnant women.Sp O2 was not statistically significant in multivariate analysis(P>0.05).ROC analysis of NT-pro BNP and RDW shows that the area under NT-pro BNP curve is 0.951,the sensitivity is 0.895,the specificity is 0.969,P=0.000,the critical value is 91.00pg/ml;the area under RDW curve is 0.697,the sensitivity is 1.000,the specificity is 0.313,P=0.009,the critical value is 19.00%.According to the correlation analysis,NT-pro BNP showed a moderate negative correlation with neonatal body weight,and its correlation coefficient was-0.538.RDW showed a low negative correlation with neonatal body weight,and its correlation coefficient was-0.354.Conclusions1.The risk of SGA in offspring of CHD pregnant women can be evaluated by the values of NT-pro BNP and RDW.2.NT-pro BNP and RDW have a certain degree of correlation with the birth weight of the offspring of CHD pregnant women respectively,which can reflect the growth and development of the fetus.