Changes And Significance Of Renal Function Biochemical Indexes In Patients With Hypertensive Disorders Of Pregnancy During Third Trimester Of Pregnancy

Objective:To investigate the changes of biochemical indexes of renal function in patients with hypertensive disorders of pregnancy in third trimester of pregnancy and its clinical significance.Methods:1. The clinical data of pregnant women who were admitted to the obstetrical department of Hebei General Hospital from January 2018 to April2019 and terminated pregnancy at 28 weeks and above were retrospectively collected,including the age of delivery,height,BMI before pregnancy,weight gain during pregnancy,pregnancy,parity,biochemical indicators of renal function in the third trimester,pregnancy comorbidities,complications and adverse pregnancy outcomes.2.The Kolmogorov-Smirnov test was used for the normality test.The measurement data conforming to the normal distribution was expressed by?x±s.T-test was used for comparison between the two groups of independent samples,and paired T-test was used for comparison between the two groups of paired samples.The measurement data that does not conform to the normal distribution was represented by M(P25,P75),the Kruskal-Wallis H test was used for comparison between the two groups of independent samples,and the Wilcoxon signed rank test was used for comparison between the two groups of paired samples;The comparison between two groups of independent samples of counting data was performed using the?~2 test and Fishener's exact probability method,and the comparison between the two groups of paired samples was performed using the Mc Nemar test.P<0.05 was considered statistically significant.The unilateral percentage method[>5th percentile(P5),or<95th percentile(P95)]was used to determine the reference range for various renal function indicators of pregnant women in the third trimester of pregnancy.Binary Logistic regression was used to construct a predictive model of placental abruption in HDP Patients,and ROC curve was used to evaluate the predictive value of the predictive model.Results:1. The reference range of biochemical indexes of renal function of pregnant women in the third trimester of pregnancy was:Urea?4.4mmol/L,Cr?67.7umol/L,UA?422.9umol/L,and GFR?103.7ml/min.2. Compared with the control group,there were statistical differences in the levels of Urea,Cr,UA and GFR in preeclampsia patients.3. Those with abnormal levels of Urea,Cr,UA,and GFR in preeclampsia patients were 3.65,2.42,2.57,and 3.53 times more likely to result in adverse pregnancy outcomes than in normal subjects,respectively.4. The prediction formula for placental abruption in HDP patients was:log(P)=8.869-0.194×(pre-pregnancy BMI)-0.188×(pregnancy weight gain)-0.033×(glomerular filtration rate),AUC was 0.796,specificity was 0.783 and Youden's index was 0.543 when the sensitivity was 0.760.Conclusions:1.Serum levels of Urea and Cr in the third trimester of pregnancy were lower than non-pregnant people,GFR was higher than non-pregnant people,but UA had no significant change.2.The levels of Urea,Cr,UA and GFR were associated with adverse pregnancy outcomes in preeclampsia patients,and those with abnormal biochemical indicators of renal function have an increased risk of adverse pregnancy outcomes.3.The area under the ROC curve of the predictive formula"log(P)=8.869-0.194×(pre-pregnancy BMI)-0.188×(pregnancy weight gain)-0.033×(glomerular filtration rate)"for placental abruption in HDP patients was 0.796.When the calculated P value exceeded 0.114,clinicians should be alert to the occurrence of placental abruption.