Maternal Mean Arterial Pressure Combined with TTR in Prediction of Preeclampsia in Early Pregnancy and Its Influence on Pregnancy Outcome

ZHAO Xuelian; YANG Qing; ZHANG Lijie; LI Ya'nan; SHAN Shuang; WANG Jinling

doi:10.13730/j.issn.2097-2148.2025.01.008

Abstract：Objective To investigate the role of maternal mean arterial pressure(MAP)combined with transthyre-tin(TTR)in predicting preeclampsia(PE)in early pregnancy and its influence on pregnancy outcomes.Methods A total of 56 pregnant women diagnosed with early-onset PE in author's hospital from October 2018 to December 2022 were se-lected as the study group,and 56 normal pregnant women during the same period were selected as the control group.The baseline data,maternal MAP,serum indexes,changes in blood lipids value and complications of the two groups of pa-tients were compared.The serum TTR concentration of patients was detected by enzyme-linked immunosorbent assay(ELISA),and the efficacy of maternal MAP combined with serum TTR in diagnosing early-onset PE was evaluated by re-ceiver operating characteristic(ROC)curve analysis.Results The gestational weeks of the pregnant women in study group was lower than that of the control group(P＜0.05).The simple effect analysis showed that,compared with pre-pregnancy,the MAP of the study group at 10-12 weeks,24-26 weeks and 34-36 weeks of pregnancy were significantly higher,the concentration of serum TTR was significantly lower(all P＜0.05);the MAP of the study group at 10-12 weeks,24-26 weeks and 34-36 weeks of pregnancy were significantly higher than those of control group,the concentration of serum TTR was significantly lower(all P＜0.05).The levels of serum pregnancy associated plasma protein A(PAPP-A),placenta growth factor(PIGF)and human chorionic gonadotropin(HCG)in the study group were lower than those in the control group,while the level of soluble fms-like tyrosine kinase 1(sFlt-1)was higher than that in the control group(all P＜0.05).The levels of total cholesterol(TC)in early and mid pregnancy of pregnant women in the study group was significantly lower than those of control group,the levels of triglycerides(TG),high density lipoprotein(HDL),low density lipoprotein(LDL)were significant-ly higher(all P＜0.05);the levels of TC,TG in late pregnancy of pregnant women in the study group was significantly higher than those of control group(all P＜0.05).The rate of cesarean section,fetal distress and oligohydramnios of pregnant women in the study group were significantly higher than those in the control group(all P＜0.05).The results of multivariate Logistic regression analysis showed that,age,MAP and TTR levels at 10-12 weeks,24-26 weeks and 34-36 weeks of pregnancy,blood lipid indexes at early and mid pregnancy,TC and TG at late pregnancy were the independ-ent influencing factors of the early-onset PE(P＜0.05).The area under the curve(AUC)predicted by the combined MAP+TTR test for early-onset PE was higher than the AUC measured by TTR and MAP individual detection(P＜0.05).Conclusion The pregnancy outcome of PE patients in early pregnancy is worse than that of normal pregnant women.The increase of MAP and TTR is the related influencing factor of PE in early pregnancy,and the combined de-tection of the two has certain predictive value in predicting PE in early pregnancy.