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PURPOSE: This study aimed to assess the predictive value of macrophage colony-stimulating factor (M-CSF) in the first trimester for hypertensive disorders complicating pregnancy (HDCP) and its association with disease severity and adverse pregnancy outcomes. HDCP pose significant risks to both maternal health and fetal health. M-CSF is implicated in the pathogenesis of HDCP by promoting inflammation and endothelial damage. METHODS: Serum levels of M-CSF were measured using an enzyme-linked immunosorbent assay, and clinical characteristics and pregnancy outcomes were compared between groups. RESULTS: Pregnant women with HDCP had significantly higher levels of proteinuria, systolic blood pressure, and diastolic blood pressure compared to those with normal pregnancy. Among patients with HDCP, the severity of disease correlated positively with serum levels of M-CSF. Furthermore, M-CSF levels in the first trimester were significantly associated with adverse pregnancy outcomes. The findings suggest that M-CSF may serve as a potential biomarker for predicting HDCP and its severity, as well as adverse pregnancy outcomes. CONCLUSIONS: Early detection and monitoring of M-CSF levels could aid in identifying high-risk pregnancies and implementing appropriate interventions to improve maternal and fetal outcomes.
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BACKGROUND: Hypertensive disorders complicating pregnancy (HDCP) and gestational diabetes mellitus (GDM) can affect the placental barrier function to varying degrees. However, current studies show that the transfer and distribution characteristics of trace elements in the maternal-fetal system are still unclear. This study investigated the effect of the placental barrier on the transfer of trace elements from mother to fetus and its relationship with HDCP and GDM. METHODS: A case-control method was used in this study. 140 pairs of samples were collected; 60 were from healthy pregnant women, and 80 were from patients with pregnancy complications. The contents of trace elements in paired samples were determined by inductively coupled plasma-mass spectrometry (ICP-MS). SPSS software was used to analyze the differences in trace element levels in matched samples of each group. The correlations were analyzed based on Pearson's correlation factor (r). RESULTS: The distribution characteristics of Fe content in the pathological group (HDCP group and GDM group) were the same as those in the normal group (umbilical cord blood > maternal blood > placenta), but there was no significant difference in the iron content in maternal blood and cord blood of pathological group. The distribution characteristics of Mn content in the pathological group (placenta > umbilical cord blood > maternal blood) were changed compared with those in the normal group (placenta > maternal blood > umbilical cord blood). In addition, the placental Cr content and cord blood Cr and Ni content of the pathological group were higher than those of the normal group. HDCP placental Cr and GDM placental Fe levels were significantly correlated with the Apgar score. CONCLUSIONS: The transfer of Fe and Mn and the placental barrier function of Cr and Ni in the maternal-fetal system of HDCP and GDM are significantly altered, which directly or indirectly increases the maternal and fetal health risk.
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Diabetes, Gestational , Hypertension, Pregnancy-Induced , Trace Elements , Pregnancy , Female , Humans , Placenta , Fetus , Fetal Blood/chemistryABSTRACT
BACKGROUND: Hypertensive disorders complicating pregnancy (HDCP) are various heterogeneous conditions. microRNA (miR)-200a-3p is involved in HDCP diagnosis. This study explored the effects of miR-200a-3p on HDCP patients. METHODS: A total of 126 singleton HDCP patients including 50 cases of gestation hypertension (GH), 42 cases of mild preeclampsia (MP) and 34 cases of severe preeclampsia (SP), were enrolled as study subjects, and 50 normal pregnant women were selected as the control. Serum miR-200a-3p expression was detected and its efficacy in HDCP diagnosis and grading was evaluated. GH, MP and SP patients were allocated to high/low miR-200a-3p expression groups. The correlation between miR-200a-3p expression and general clinical indexes was analyzed. HDCP patients were allocated to high/low miR-200a-3p expression group and maternal and fetal outcomes were followed up. Effects of miR-200a-3p expression on adverse pregnancy outcome incidence were analyzed. RESULTS: miR-200a-3p expression in the serum of HDCP patients was upregulated. The sensitivity and specificity of serum miR-200a-3p level > 1.201 were 87.3% and 96.0%, respectively. Serum miR-200a-3p level in GH, MP and SP patients was increased with the aggravation of the disease. The cut-off value and area under the curve (AUC) of miR-200a-3p for GH, MP and SP diagnosis were 1.145 and 0.9094 (82.0% sensitivity and 88.0% specificity), 1.541 and 0.8126 (73.8% sensitivity and 76.0% specificity), and 1.866 and 0.7367 (64.7% sensitivity and 76.2% specificity), respectively. Serum miR-200a-3p level was correlated with general clinical indexes, fetal birth weight, systolic to diastolic ratio, and fetal growth restriction incidence. High serum miR-200a-3p expression in HDCP patients was associated with increased adverse pregnancy outcomes. CONCLUSION: High miR-200a-3p expression could help to diagnose HDCP, judge severity and was associated with increased adverse pregnancy outcomes.
Subject(s)
Hypertension, Pregnancy-Induced , MicroRNAs , Pre-Eclampsia , Female , Fetal Growth Retardation , Humans , Hypertension, Pregnancy-Induced/diagnosis , Pregnancy , Pregnancy OutcomeABSTRACT
Objective To investigate the correlation between the polymorphism of 5,10-methylenetetrahydrofolate reductase ( MTHFR) gene rs!801131 and hypertensive disorders complicating pregnancy ( HDCP ) in Qinghai Han nationality. Methods The polymorphism of MTHFR rsl801131 in 120 pregnant women with HDCP (HDCP group) and 120 normal pregnant women ( control group) were detected by restriction fragment length polymorphism polymerase chain reaction (PCR-RFLP) and verified by sequencing. Results The frequencies of AA, AC, and CC genotype of MTHFR gene in the HDCP group were 56. 67% , 32. 50% , and 10. 83% respectively, and those in the control group were 74.17%, 23.33% and 2. 50% respectively (P<0. 05, the distribution of genotype was different significantly between the two groups). The frequency of AA genotype of HDCP group (56. 67%) was lower than that of control group (74. 17%, P<0. 05) , the frequency of CC genotype of HDCP group ( 10. 83%) was higher than that of control group ( 2. 50% , P< 0. 05) , while there was no significant difference in the frequency of AC genotype between HDCP group and control group ( P<0. 05). The frequency distribution of alleles A and C of MTHFR rsl801131 polymorphism was significantly different between the HDCP group and the control group (P<0. 001) , and the frequency of allele C in the HDCP group was significantly higher than that in the control group (X2 = 12. 229, 0R=L 574, 95% C/= 1. 181-2. 099, P<0. 001). Conclusion The polymorphism of MTHFR rsl801131 is related to the occurrence of HDCP in Qinghai Han population. The C gene might be the susceptibility gene of HDCP, and CC genotype might be the susceptibility genotype of HDCP.
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OBJECTIVES: Hypertensive disorders complicating pregnancy is a kind of disease that seriously endangers the health of pregnant women and fetuses with high incidence. This study aims to analyze the prevalence of pregnant women with hypertensive disorders complicating pregnancy and the influential factors for critical pregnant women, and to provide basis for intervention measures. METHODS: In an institution-based cross-sectional study, 100 683 pregnant women, who gave birth in all maternal and child health hospitals of Hunan Province from January 1, 2012 to December 31, 2019, were collected, and 6 579 pregnant women with hypertensive disorders complicating pregnancy were monitored. All data were analyzed through SAS9.4 software. The basic situation, clinical data, outcome, and complications of pregnant women were analyzed, and the risk factors for critical pregnant women with hypertensive disorders complicating pregnancy were analyzed. RESULTS: The prevalence rate of hypertensive disorder complicating pregnancy was increased from 4.3% in 2012 to 7.1% in 2019, and the proportion of hypertensive disorder complicating pregnant women with complications in the hypertensive disorder complicating pregnant women was increased from 28.1% in 2012 to 83.7% in 2019. Elderly pregnant women accounted for 22.2%, married women accounted for 99.9%, women with university degree accounted for 49.5%, one pregnancy accounted for 38%, and zero delivery accounted for 63.5%. In the past, 18.4% of pregnant women had more than one cesarean section, accounting for 18.4%. About 99.0% of pregnant women had 5-10 antenatal check-ups, 72.6% had complications, and 93.8% were terminated when they were discharged. The first 3 complications were anemia in 2 355 cases (29.3%), gestational diabetes in 1 886 cases (23.4%), and subclinical hypothyroidism in 947 cases (11.8%). Logistic regression analysis showed that uterine rupture, placental abruption, placenta previa, anemia, and heart disease were independent risk factors for critical pregnant women. CONCLUSIONS: The prevalence of hypertensive disorders complicating pregnancy is on the rise. Pregnancy examination should be enhanced to identify the complications such as hypothyroidism, gestational diabetes, and anemia. Prevention and treatment measures should be actively taken for uterine rupture, placental abruption, placenta previa, anemia, and heart disease.
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Hypertension, Pregnancy-Induced , Pregnancy Complications , Aged , Cesarean Section , Child , Cross-Sectional Studies , Female , Humans , Hypertension, Pregnancy-Induced/epidemiology , Male , Placenta , Pregnancy , Pregnancy Complications/epidemiology , Pregnancy Outcome , Pregnant Women , PrevalenceABSTRACT
Objective: Study the association of adropin and hypertensive disorders complicating pregnancy (HDCP). Methods: Patients with HDCP were matched with normotensive women (47 pairs). Adropin concentrations were detected by enzyme-linked immunosorbent assay. Results: Compared with the controls, the serum adropin levels were lower in the HDCP group (P < 0.001) and in HDCP subgroups (gestational hypertension, mild preeclampisa, and severe preeclampsia, term, preterm, early onset, and late onset) (all P < 0.05). After adjustment for confounders, adropin remained negatively associated with HDCP (P = 0.027). Conclusion: Lower adropin concentration is significantly associated with HDCP, suggesting that higher or normal adropin levels may be protective against HDCP.
Subject(s)
Hypertension, Pregnancy-Induced/blood , Intercellular Signaling Peptides and Proteins/blood , Adult , Case-Control Studies , Female , Humans , PregnancyABSTRACT
Objective@#To investigate the effect of hypertensive disorder complicating pregnancy (HDCP) on the mortality and early complications of premature infants.@*Methods@#The general clinical data of preterm infants with gestational age 24-36+ 6 weeks were collected from the cooperative units in the task group from January 1, 2013 to December 31, 2014.According to the severity of HDCP, the infants were divided into 4 groups: HDCP group, preeclampsia group, eclampsia group and non HDCP group, the mortality and major complications of preterm infants were compared, and the influencing factors were analyzed.@*Results@#The mortality rate of preterm in the HDCP group was significantly higher than that of non HDCP group, and there was statistical significance (χ2=9.970, P=0.019). Eclampsia had a highest fatality rate (4.8%) in the early stage, compared with non HDCP group (2.2%), and the difference was statistically significant.Comparison of HDCP group (1.8%) and eclampsia group (3.2%) suggested that there was no statistically significant difference.The incidence of respiratory distress syndrome (RDS) in preterm in HDCP group was significantly higher than that of non HDCP group, and there was statistical significance (χ2=13.241, P=0.004). Eclampsia group showed the highest incidence (35.4%), compared with non HDCP group (16.2%), the difference was statistically significant, but compared with HDCP group (19.9%), preeclampsia group (17.1%), there was no significant diffe-rence.The incidence of bronchopulmonary dysplasia (BPD) in preterm in HDCP group was significantly higher than that of non HDCP group (χ2=9.592, P=0.022), the highest incidence showed up in eclampsia group (9.7%), compared with non HDCP group (2.0%) and HDCP group (1.7%), the difference was statistically significant.But there was no statistically significant difference, compared with preeclampsia group.As the degree of HDCP aggravated, the incidence of BPD gradually rose.There was no significant impact on necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), intraventricular hemorrhage (IVH) and sepsis of HDCP (χ2=7.054, 7.214, 0.358, 3.852; P=0.070, 0.065, 0.949, 0.278). Considering the overall outcome of the child, that was, whether the child died or survived, he had at least one complication, and HDCP had an effect on it (χ2=15.697, P=0.001), so the incidence increased while the degree of HDCP rose gradually.After adjusting gestational age, birth weight, sex, way of delivery, placental abruption and front placenta, prenatal hormonal, gestational diabetes, neonatal asphyxia and other factors, the results displayed that HDCP was the factor leading to the death of premature baby (OR=2.159, 95%CI: 1.093-4.266), and comparison between preeclampsia and eclampsia showed no statistical difference (P=0.714, 0.389); HDCP had no significant influence on RDS, BDP, ICH, NEC, ROP and sepsis.@*Conclusions@#HDCP leads to increased risk of premature death, but also leads to the increased incidence of RDS and BPD, but it had no obvious effect on NEC, ROP, IVH, sepsis and other complications.
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Objective To observe the features of the changes in the whole blood N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in pregnant patients with complication of hypertensive disorders,its correlation to the severity of the illness,and to investigate the diagnostic value of point-of-care testing of NT-proBNP in patients with hypertensive disorders complicating pregnancy.Methods A prospective observation was conducted.Sixty-nine patients with hypertensive disorders complicating pregnancy admitted to Department of Critical Care Medicine of Liaocheng People's Hospital in Shandong Province from April 2013 to April 2015 were enrolled.All patients were divided into gestational hypertension group (n =16),preeclampsia group (n =30) and eclampsia group (n =23).At the same time,30 age-matched normal pregnant women were enrolled as the control group.The acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score of all patients with hypertensive disorders complicating pregnancy were calculated within 24 hours after intensive care unit (ICU) admission.NT-proBNP in venous blood at 1,3,5 days after ICU admission was determined with point-of-care testing,in order to analyze the correlation of changes in NT-proBNP value in each group and the severity of the disorder.Receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic value of NT-proBNP in the whole blood in hypertensive disorder complicating pregnancy.Results The APACHE Ⅱ score of the eclampsia group was significantly higher than that of the preeclampsia group,and it was higher than that of gestational hypertension group (15.91 ± 1.06,13.73 ± 1.09,10.31 ± 1.10,all P ＜ 0.01).The NT-proBNP in normal pregnancy group was lower than 125.00 ng/L,with a mean of 90.00 (79.75,100.00) ng/L.With the aggravation of the disease,NT-proBNP was gradually increased.On the first day in ICU,the NT-proBNP of the eclampsia gronp was significantly higher than that of the preeclampsia group,and it was higher in preeclampsia group than that of gestational hypertension group [ng/L:1960.00 (1 226.00,3 229.00),859.50 (626.75,2439.00),505.00 (171.25,604.05),P ＜ 0.05 or P ＜ 0.01].With the extension of duration of treatment,the levels of NT-proBNP (ng/L) in the eclampsia group,preeclampsia group,and gestational hypertension group was gradually decreased,and had a statistically significant difference on the fifth day as compared with that of the first day [310.00 (210.00,430.00) vs.1 960.00 (1 226.00,3 229.00) in eclampsia group,265.00 (229.50,333.25) vs.859.50 (626.75,2439.00) in preeclampsia group,and 203.00 (115.50,259.25) vs.505.00 (171.25,604.05) in gestational hypertension group,all P ＜ 0.01].APACHE Ⅱ score of the patient with hypertensive disorders complicating pregnancy was positively correlated with the level of NT-proBNP on the first day in ICU (r =0.795,P =0.000).It was shown by ROC curve analysis that the area under the ROC curve (AUC) of NT-proBNP in the whole blood for the diagnosis of the patient with hypertensive disorder complicating pregnancy was 0.986 [95％ confidence interval (95％C/) =0.753-0.924].When the cutoff value was 122.50 ng/L,the sensitivity was 97.1％,and the specificity was 100.0％.No patient died,all the 69 patients recovered and discharged.Conclusions The levels of NT-proBNP in the whole blood in the patients with hypertensive disorder complicating pregnancy,especially those with eclampsia,were significantly higher,and it was correlated with the severity of illness.After treatment,the levels were gradually lowered with the improvement of the disease.Therefore,it is concluded that the point-of-care testing of NT-proBNP in the whole blood has an excellent value for the diagnosis and evaluation of hypertensive disorder complication pregnancy.
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Objective To explore the clinical value of detecting serum cystatinC (CysC) combined with β2‐microglobulin(β2‐MG) in assessing early kidney damage for patients with hypertensive disorder complicating pregnancy (HDCP) .Methods Totally 108 patients with HDCP were selected ,including 41 cases of gestational hypertension ,30 cases of mild preeclampsia ,37 cases of se‐vere preeclampsia ,moreover ,40 normal pregnant women were selected as control .The levels of serum CysC ,serum β2‐MG and ser‐um creatinine(Cr) were tested with automatic biochemistry analysator .Results The levels of serum CysC and β2‐MG in gestational hypertension group ,mild preeclampsia group and severe preeclampsia group were significantly higher than the control group (P 0 .05) .In addition ,the results of correlation analysis showed there was a positive correlation among Cys‐C ,β2‐MG and Cr in the patients with HDCP .Conclusion There will be an important clinical value to evaluate the progression of the disease and diagnose early kidney damage through joint detectation of serum Cys‐C ,β2‐MG and and Cr .
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The aim of the present study was to explore the association between the expression of microRNA (miRNA)-181b and plasminogen activator inhibitor-1 (PAI-1) in the placental tissue of pregnant females with a hypertensive disorder complicating pregnancy (HDCP). Placental tissue samples were obtained from 48 patients with HDCP and 40 females with a normal pregnancy. The levels of miRNA-181b and PAI-1 mRNA were determined by the reverse transcription-quantitative polymerase chain reaction (RT-qPCR). The expression of PAI-1 protein was analyzed by western blotting. Vascular smooth muscle cells (VSMCs) were transfected with the pEGP-miRNA-181b plasmid using Lipofectamine® 2000. Transfection efficiency was confirmed by immunohistochemical analysis. The levels of miRNA-181b in the placental tissue of patients with HDCP were lower than those in the control group, whereas the levels of PAI-1 mRNA in the placental tissue of patients with HDCP were higher than those in the control group. The expression of the PAI-1 protein in the HDCP group was higher than that in the control group. Following transfection of VSMCs with plasmid pGCMV/EGFP/miRNA-181b, the levels of PAI-1 mRNA were reduced while the levels of miRNA-181 were upregulated. Furthermore, the expression levels of PAI-1 protein were lower than those in the control group. The levels of miRNA-181b and PAI-1 mRNA were strongly associated with HDCP. Thus, miRNA-181b may play an important role in the regulation of PAI-1. PAI-1 and miRNA-181b may be novel biomarkers to be used in HDCP therapy.
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Objective ThrouGh the detection of heat shock protein 90(HSP90)Gene expression in the peripheral blood in in patients with hypertensive disorders complicatinG preGnancy( HDCP ),to understand its role in the pathophysioloGy of HDCP. Methods The expression of HSP90 was observed in Groups of normal preGnant women,Gestational hypertension patients,mild preeclampsia patients,severe preeclampsia patients by ELISA. Results The expression of HSP90 in peripheral blood of Gestational hypertension Group,mild preeclampsia Group,severe preeclampsia Group were siGnificantly hiGher than normal preGnant Group( P<0. 0l ) . Conclusion HSP90 may have close relationship with the onset and development of HDCP. It can predict HDCP by detectinG the level of HSP90 in peripheral blood.
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Objective To detect heat shock protein 90 (HSP90) expression in the placenta in pregnancy induced hypertension in order to understand its role in the pathophysiology of hypertensive disorders comphcating pregnancy (HDCP).Methods The gene and protein expression of HSP90 in the placenta of normal pregnant women,gestational hypertension patients,mild preeclampsia patients,severe preeclampsia patients,by RT-PCR and Western blotting.Results The gene and protein expression of HSP90 in placenta of gestational hypertension group,mild preeclampsia group,severe preeclampsia group were significantly higher than that of normal pregnant group (P ＜ 0.01),and it showed the increased progressively with the increasing of disease stage.Conclusion HSP90 may be involved in the onset and development of HDCP.Monitoring HSP90 concentration in the placenta which is the initial theoretical basis for the target as HSP90 for the treatment of HDCP.
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Objectives: Hypertensive disorders complicating pregnancy(HDCP) has a long-term deleterious effect.This study aimed to investigate the changes of cognitive function in women with HDCP and explore their possible mechanism.Methods: Fifty-three patients with HDCP and 22 normal pregnant women were included in this study,their cognitive functions assessed 60-80 days after delivery by word learning and delayed recall test,symbol digit substitution test,animal category fluency test,block design,trail making test(Part A) and digit span test.The results of the cognitive tests were compared between the HDCP and normal control groups.Results: Cognitive performances of the severe preeclampsia patients differed significantly from those of the normal individuals on the tests of word learning(P
