The Effect of PT,APTT and UA on the Severity of Hypertension During Pregnancy and the Prediction of Adverse Pregnancy Outcomes

DONG Zhiwen; YU Meng; HUANG Xin

doi:10.3969/j.issn.2096-305X.2025.02.013

Abstract：Objective The purpose of this study was to investigate the predictive value of prothrombin time(PT),partial thromboplastin time(APTT)and serum uric acid(UA)level for disease severity and adverse pregnancy outcomes in patients with hypertensive disorders of pregnancy(HDP).Methods A total of 105 patients with HDP who were treated in the Department of Obstetrics in the First Affiliated Hospital of Jinzhou Medical University from June 2021 to December 2023 were retrospectively selected to establish the model 1,which was divided into a simple HDP group(42 cases),a preeclampsia group(40 cases)and a severe preeclampsia group(23 cases)according to the severity of the disease;according to the pregnancy outcomes of the included patients,the model 2 was established,and the patients were divided into normal pregnancy outcome group(66 cases)and adverse pregnancy outcome group(39 cases).The general clinical data and laboratory indicators of the patients were compared,and the correlation of PT,APTT and UA with the severity of the disease and pregnancy outcome was analyzed.Binary Logistic regression analysis was used to explore whether PT,APTT and UA were independent predictors of pregnancy outcomes.Receiver operating characteristic curve(ROC)was used to analyze whether PT,APTT and UA could be used as predictors of pregnancy outcomes in HDP patients.Results In Model 1,the levels of PT and APTT in the simple HDP group,the mild preeclampsia group and the severe preeclampsia group decreased successively,while the levels of UA increased successively among the three groups,with statistical significance(P＜0.05);in Model 2,multivariate binary Logistic regression analysis indicated that PT,APTT and UA were still risk factors for adverse pregnancy outcomes(P＜0.05),and UA had the strongest predictive value(OR=1.455,95％CI:1.119-2.034).The AUC of PT,APTT and UA for predicting pregnancy outcomes in patients with HDP were 0.672(95％CI:0.559-0.785,P=0.001),0.762(95％CI:0.672-0.853,P=0.001),0.766(95％CI:0.665-0.866,respectively.P=0.001),and the combined AUC of PT,APTT and UA was 0.819(95％CI:0.728-0.910,P＜0.001),which was significantly higher than that of single detection.When the optimal cut-off value of the combined detection value of PT,APTT and UA was 0.573,the predictive sensitivity was 74.4％and the specificity was 82.9％.Conclusion The levels of PT,APTT and UA are related to the severity of HDP and adverse pregnancy outcomes.The high levels of PT and APTT and the low levels of UA can be used as predictors of the severity of HDP and adverse pregnancy outcomes.