Value of Fetal Serum Free Estriol Combined with Middle Cerebral Artery Blood Flow Parameters in Predicting Adverse Outcomes of Mothers and Infants in High-Risk Pregnancies
SUN Jinxian, JIAO Shumin
Department of Obstetrics, Xianyang Rainbow Hospital, Xianyang Shaanxi 712000
Abstract：【Objective】To investigate the predictive value of serum free estriol (uE3) and fetal middle cerebral artery blood flow parameters in maternal and infant adverse outcomes in high-risk pregnant women. 【Methods】 A total of 95 high-risk pregnant women (the observation group) who received regular antenatal check-up in our hospital from February 2019 to February 2021 were selected and divided into the poor group and the good group according to pregnancy outcomes. In addition, 88 healthy volunteers who underwent regular birth examination in our hospital during the same period were selected as the control group. The clinical data, serum free estriol (uE3) levels and fetal middle cerebral artery blood flow parameters [middle cerebral artery pulsation index (PI), resistance index (RI), end-systolic peak/end-diastolic peak (S/D)] were compared between the two groups. Logistic regression was used to analyze the influencing factors of adverse pregnancy outcomes in high-risk pregnant women. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of fetal middle cerebral artery blood flow parameters and maternal serum uE3 level for adverse pregnancy outcomes in high-risk pregnant women. 【Results】Fetal middle cerebral artery PI, RI, S/D and serum uE3 levels in observation group were lower than those in control group (P<0.05). The incidence of adverse pregnancy outcome was 35.79%. The levels of fetal middle cerebral artery PI, RI, S/D and serum uE3 in the adverse group were lower than those in the good group (P<0.05). The history of miscarriage and the proportion of placenta previa in the poor group were significantly different from those in the good group (P<0.05). Logistic multivariate regression analysis showed that fetal PI, RI, S/D, serum uE3 level and placental previa were independent risk factors for adverse pregnancy outcomes in high-risk pregnant women (P<0.05). ROC analysis results showed that the optimal cut-off points for fetal middle cerebral artery PI, RI, S/D and maternal serum uE3 levels to predict adverse pregnancy outcomes were 0.92, 0.42, 3.20 and 0.66 ng/mL, respectively. The area under the curve (AUC) were 0.797, 0.756, 0.708 and 0.766, respectively. and the joint prediction The specificity and AUC of combined measurements of middle cerebral artery and uE3 were 98.33% and 0.838, respectively. 【Conclusion】The levels of fetal middle cerebral artery PI, RI, S/D and serum uE3 of pregnant women with adverse pregnancy outcomes are decreased. Monitoring the levels of PI, RI, S/D in the middle cerebral artery and serum uE3 of pregnant women with high-risk pregnancies has certain predictive value for adverse pregnancy outcomes.
孙金线, 焦淑敏. 高危妊娠孕妇血清游离雌三醇联合胎儿大脑中动脉血流参数对母婴不良结局的预测价值[J]. 医学临床研究, 2024, 41(9): 1339-1342.
SUN Jinxian, JIAO Shumin. Value of Fetal Serum Free Estriol Combined with Middle Cerebral Artery Blood Flow Parameters in Predicting Adverse Outcomes of Mothers and Infants in High-Risk Pregnancies. JOURNAL OF CLINICAL RESEARCH, 2024, 41(9): 1339-1342.
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2024, Vol. 41 
