Clinical Study On The Changes Of Peripheral Blood Parameters In Pregnant Women With Preeclampsia Complicated With Fetal Growth Restriction And Its Correlation With Perinatal Outcome

ObjectiveTo investigate the correlation between the change trend of hematological parameters and perinatal outcome in pregnant women with preeclampsia complicated with fetal growth restriction,assess the value of BP artificial neural network in predicting the occurrence of FGR and its adverse perinatal outcome in pregnant women with preeclampsia complicated with fetal growth restriction.MethodsCollected in January 2010-December 2018 in fujian province maternity and child care maternity hospital childbirth preeclampsia with FGR clinical data 270 cases of pregnant women,Clinical data of pregnant women without FGR and FGR alone during the same period were collected.,As the control group,270 cases in each group were used to retrospectively analyze the differences in glucose and lipid metabolism indexes,platelet parameters,serum inflammatory indexes,liver and kidney function,maternal complications and perinatal outcomes in the three groups,analyze the correlation between the above hematological parameters and the occurrence of FGR and perinatal outcomes in preeclampsia,and construct BP artificial neural network to evaluate the predictive value of related parameters on adverse perinatal outcomes.Results(1)TC,TG and LDL levels in the FGR group with preeclampsia were higher than those in the FGR group,and apo-a1 levels were lower than those in the FGR group,with statistically significant differences(P < 0.05).TG,LDL and HDL of FGR group with preeclampsia were higher than that of FGR group without preeclampsia,and the difference was statistically significant(P < 0.05).(2)FGR group with preeclampsia and FGR group showed no statistically significant difference in fasting blood glucose and OGTT0,OGTT1 and OGTT2 in late pregnancy(P>0.05).There was no statistically significant difference between FGR group with preeclampsia and FGR group without preeclampsia and OGTT0,OGTT1 and OGTT2 in late pregnancy(P>0.05).(3)The value of PLT in the FGR group with preeclampsia was lower than that in the FGR group,and MPV and PDW were higher than that in the FGR group,with statistically significant differences(P < 0.05).PLT in the FGR group with preeclampsia was lower than that of the FGR group without preeclampsia,and MPV and PDW were higher than that of the FGR group without preeclampsia,with statistically significant differences(P < 0.05).(4)The value of PT and TT d-dimer in the FGR group with preeclampsia were greater than that in the FGRgroup,and the difference was statistically significant(P <0.05).PT and TT in the FGR group with preeclampsia were greater than that of the FGR group without preeclampsia,and the difference was statistically significant(P < 0.05).(5)The levels of ALT,GGT,uric acid and total bile acid in the FGR group with preeclampsia were higher than those in the FGR group alone,with statistically significant differences(P < 0.05).AST and total bile acid levels in the FGR group with preeclampsia were higher than that of the FGR group without preeclampsia,with no statistically significant difference(P>0.05).The level of LDH was higher than that of the FGR group without preeclampsia,and the difference was statistically significant(P< 0.05).(6)The incidence of HELLP syndrome,postpartum hemorrhage,cholestasis,premature rupture of membranes,placental abruption,placental adhesion and amniotic fluid fecal contamination in the FGR group was higher than that in the FGR group,with statistically significant differences(P < 0.05).The incidence of fetal distress,placental adhesion and postpartum hemorrhage in the FGR group with preeclampsia was significantly higher than that in the FGR group without preeclampsia(P < 0.05).(7)Preeclampsia complicated with FGR group birth body mass,body length,the placenta weight below preeclampsia complicated with FGR group and simple FGR group,incidence of preterm infants,neonatal mild asphyxia rate,incidence of severe asphyxia is greater than the preeclampsia complicated with FGR group and simple FGR group,no statistically significant difference(P < 0.05),while the stillbirth and neonatal respiratory distress syndrome,neonatal pneumonia,neonatal brain injury,the incidence of cerebral hemorrhage,there were no statistically significant difference(P > 0.05).(8)NLR and PLR in the FGR group with preeclampsia were greater than that in the FGR group,with statistically significant differences(P < 0.05).The NLR and PLR of the FGR group with preeclampsia were greater than that of the FGR group without preeclampsia,and the difference was statistically significant(P>0.05).(9)BP artificial neural network was constructed by taking 14 factors(P < 0.05)of pregnant women in the analysis of intergroup differences as input values: age,weight gain,inflammatory index(NLR,PLR),coagulation index(PT,TT),lipid index(HDL,LDL,TG),platelet parameter(MPV,PCT),uric acid,LDH,and total bile acid.The neural network had an accuracy rate of 84.3% in predicting preeclampsia with FGR,80.1% in predicting postpartum hemorrhage,77.6% in predicting fetal distress,80.3%in predicting premature rupture of membranes,76.3% in predicting preterm delivery,and 81.9% in predicting the severity of FGR.(10)Preeclampsia patients complicated with FGR group of newborn body quality related factors analysis,multiple linear regression model shows that pregnant women age,gestational age,pregnancy,childbirth,body quality,delivery quality of precursor,LDL,NLR,OGTT2,propagated,MPV,PCT positively correlated with neonatal body quality,PT,HDL,LDH,APO A1 and neonatal body quality negatively correlated(P <0.05)..ConclusionMonitoring the change trend of related hematological indicators such as inflammatory indicators,coagulation indicators,blood lipid indicators,platelet parameters,uric acid and other related hematological indicators can help to assess the risk of complications in patients with preeclampsia complicated with FGR.Pregnant women’age and weight increment,inflammatory index and blood coagulation indexes and blood lipids index and platelet parameters,uric acid,LDH,total bile acid 14 factors to construct the BP artificial neural network to predict preeclampsia pregnant women complicated with FGR happen and bad among postpartum hemorrhage,fetal distress,premature rupture of membranes,preterm labor,fetal growth restriction degree has a certain predictive value.