The evaluate value of combined plasma ET-1 and NO levels in maternal and infant outcomes of patients with hypertensive disorders in pregnancy

doi:10.11958/20252166

Abstract

Abstract:

Objective To explore the value of combined evaluation of plasma endothelin-1 (ET-1) and nitric oxide (NO) levels in maternal and infant outcomes of patients with hypertensive disorders of pregnancy (HDP). Methods A total of 228 patients with HDP were selected. The levels of plasma ET-1 and NO in all patients were detected, and adverse maternal outcomes and adverse neonatal outcomes were statistically analyzed. The receiver operating characteristic (ROC) curve was drawn to analyze the evaluation value of plasma ET-1 and NO levels for outcomes of parturients and neonates. The influencing factors of adverse outcomes in parturients and neonates of patients with HDP were analyzed through multivariate Logistic regression, and the importance ranking of the influencing factors was visualized. Results The incidence of adverse outcomes in parturients of HDP patients was 22.4%, and the incidence of adverse outcomes in neonates was 30.3%. The plasma ET-1 levels of HDP patients with adverse maternal outcomes and adverse neonatal outcomes were higher than those with normal outcomes, and NO levels were lower than those with normal outcomes (P<0.05). The area under the receiver operating characteristic curve (AUC) for the combined prediction of adverse maternal outcomes using plasma ET-1 and NO levels was 0.819 (95%CI：0.763-0.867), while the AUC for predicting adverse neonatal outcomes reached 0.855 (95%CI：0.803-0.898). Advanced maternal age, preeclampsia, severe proteinuri and elevated ET-1 levels were identified as independent risk factors for adverse outcomes in parturients and neonatal of HDP patients. The elevated NO levels demonstrated a protective effect, serving as an independent protective factor (P<0.05). The top 5 factors in terms of the importance of each factor for adverse maternal outcomes were ET-1, NO, age, degree of proteinuria and disease type in sequence. The top 5 factors in terms of the importance of each factor for adverse neonatal outcome were NO, ET-1, age, disease type and degree of proteinuria in sequence. Conclusion The combination of ET-1 and NO has a high evaluation value for the adverse outcomes of parturients and neonates in patients with HDP.

Key words: hypertension, pregnancy-induced, endothelin-1, nitric oxide, pregnancy outcome, maternal and infant outcomes

CLC Number:

R714.252

Figures/Tables 9

References 23

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产妇结局	n	ET-1/（ng/L）	NO/（μmol/L）
正常结局	177	76.84±8.36	35.81±5.30
不良结局	51	84.62±8.72	31.06±5.84
t		5.800^＊＊	5.510^＊＊

产妇结局	n	ET-1/（ng/L）	NO/（μmol/L）
正常结局	177	76.84±8.36	35.81±5.30
不良结局	51	84.62±8.72	31.06±5.84
t		5.800^＊＊	5.510^＊＊

新生儿结局	n	ET-1/（ng/L）	NO/（μmol/L）
正常结局	159	75.58±9.06	36.72±6.28
不良结局	69	84.09±8.92	30.22±6.16
t		6.546^＊＊	7.221^＊＊

新生儿结局	n	ET-1/（ng/L）	NO/（μmol/L）
正常结局	159	75.58±9.06	36.72±6.28
不良结局	69	84.09±8.92	30.22±6.16
t		6.546^＊＊	7.221^＊＊

指标	AUC（95%CI）	P	敏感度	特异度	约登指数
ET-1	0.739（0.677~0.795）	<0.001	0.647	0.791	0.438
NO	0.757（0.696~0.811）	<0.001	0.706	0.735	0.440
联合	0.819（0.763~0.867）	<0.001	0.784	0.729	0.513