Value of Pregnancy-Associated Plasma Protein-A and Platelet Endothelial Cell Adhesion Molecule-1 in Evaluating the Pregnancy Outcomes of Patients with Hypertension in Pregnancy

doi:10.16458/j.cnki.1007-0893.2025.18.016

Abstract：Objective: To analyze the value of pregnancy-associated plasma protein-A (PAPP-A) and platelet endothelial cell adhesion molecule-1 (PECAM-1) in evaluating the pregnancy outcomes of patients with hypertensive disorders in pregnancy (HDP). Methods: A retrospective study was conducted on the clinical data of 180 HDP patients admitted to Nanyang Central Hospital from December 2022 to March 2025. The patients were divided into a good outcome group (115 cases) and an adverse outcome group (65 cases) according to their pregnancy outcomes. General information of the two groups was collected, and the incidence of adverse pregnancy outcomes was analyzed. Univariate analysis and logistic regression analysis were used to identify the influencing factors of pregnancy outcomes in HDP patients. The predictive value of PAPP-A and PECAM-1 alone or in combination for pregnancy outcomes was evaluated using receiver operating characteristic (ROC) curves. Results: Among the 65 patients with adverse pregnancy outcomes, maternal complications mainly included: preeclampsia in 10 cases (15.38%), eclampsia in 5 cases (7.69%), hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome in 8 cases (12.31%), placental abruption in 7 cases (10.77%), and postpartum hemorrhage requiring blood transfusion or intensive care unit (ICU) intervention in 12 cases (18.46%). Fetal problems mainly included: preterm birth in 15 cases (23.03%), intrauterine growth restriction in 10 cases (15.38%), low birth weight in 18 cases (27.69%), neonatal asphyxia in 9 cases (13.85%), stillbirth/early fetal death in 3 cases (4.62%), and admission to the neonatal intensive care unit (NICU) for ≥48 hours in 14 cases (21.54%). In the adverse outcome group, 42 patients (64.62%) delivered before 36 weeks of gestation, which was higher than 41 patients (35.65%) in the good outcome group. Serum levels of PAPP-A and PECAM-1 were higher in the adverse outcome group, with statistically significant differences (P < 0.05). Multivariate logistic regression analysis showed that gestational age, PAPP-A > 1.249 ng·mL⁻¹, and PECAM-1 > 15.687 μg·L⁻¹ were independent risk factors for pregnancy outcomes in HDP patients (P < 0.05). ROC analysis showed that PAPP-A, PECAM-1 alone or in combination could be used to predict pregnancy outcomes in HDP patients, with area under the curve (AUC) values of 0.763, 0.818, and 0.915, respectively (P < 0.05). Conclusion: PAPP-A and PECAM-1 can be used to predict pregnancy outcomes, and combined detection has higher predictive efficacy than individual detection.