https://orcid.org/0000-0003-0977-2712
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ABSTRACT
Background
To investigate the effects of down’s screening markers and maternal characteristics on preeclampsia (PE) pregnancy outcome during early and middle pregnancy.
Methods
A retrospective study of a cohort of 246 PE and 18,709 No-PE pregnant women who participated in Down’s screening during early and middle pregnancy was performed. Clinical data of pregnancy-related were collected. Multivariate binary logistic regression was used to analyze the adjusted odds ratio (aOR) and 95% confidence interval (CI) of Down’s screening markers, maternal characteristics, pregnancy outcome, and other related variables, and to evaluate the influencing factors of each indicator on PE. P < .05 was considered to be statistically significant.
Results
Compared with the non-PE group, the concentration and median multiple (MoM) of pregnancy-associated plasma protein-A (PAPP-A) and free beta subunit of human chorionic gonadotropin (free β-hCG) in PE group were both lower (P < .001). Multivariate binary logistic regression analysis showed that low birth weight, hydronephrosis, premature delivery, fetal growth retardation, cesarean section, live birth, hyperlipemia, infection, decreased free β-hCG and first trimester maternal weight were risk factors for PE (aOR were: 7.552, 6.684, 4.154, 3.762, 3.612, 2.454, 1.757, 1.562, 1.270, and 1.077, respectively), while uterine scar, premature rupture of membranes and elevated PAPP-A were protective factors of PE (aOR were: 0.222, 0.328 and 0.612, respectively).
Conclusion
Decreased maternal serum PAPP-A level, increased free β-hCG, hyperlipemia, premature delivery, cesarean section, live birth, hydronephrosis, fetal growth retardation, low birth weight, and infection are risk factors for PE, while uterine scar and premature rupture of membrane are protective factors for PE.
Abbreviations
PAPP-A, pregnancy associated plasma protein A; free β-hCG, free beta human chorionic gonadotropin; AFP, alpha-fetoprotein; NT, nuchal transparency; HDP, hypertensive disorders of pregnancy; PE, preeclampsia; SPE, severe preeclampsia; MoM, multiple of the median; GDM, gestational diabetes mellitus; DS, Down’s syndrome; NTD, neural tube defects; OR, odds ratios; aOR, adjusted Odds Ratio; CI, confidence intervals; PlGF, Placental Growth factor.
Acknowledgments
The authors are grateful to all of the participants and contributors. We would like to thank Songhe Chen from Hangzhou Women’s Hospital for helping to collect the data. We would also like to thank Xiao Lu of the Data Analysis Department, Zhejiang Biosan Biochemical Technologies Co., Ltd., for their contribution to data matching.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Author Contributions
B. Wu and W.W. Ning, design and statistical analysis; Y.J. Chen and W.W. Ning wrote the first draft of the manuscript. C.H. Wen and B. Wu, provision of study material or patients; Y.M. Chen, B. Wu and H.M Zhang, writing-review & editing. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Data availability statement
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
Ethics approval and consent to participate
The study has been conducted under the approval of the Human Research Ethics Committee of the Hangzhou Women’s Hospital (Hangzhou Maternity and Child Health Care Hospital) Ethics Committee of hospital ([2020] medical ethics A (010) No. 11), and the procedures have been performed in accordance with the Declaration of Helsinki. Patients’ consents were not required because this was a retrospective study.