[Predictive value analysis of Down's screening serological indicators in the second trimester for gestational hypertension].

Objective

To discuss the prediction efficacy of Down's screening serological indicators in the second trimester of gestational hypertension (GH).

Methods

64 849 pregnant women who had undergone regular check-ups at the Beijing Obstetrics and Gynecology Hospital from June 2013 to June 2019 and finally gave birth were the subjects of the study. There were 3 808 cases of the GH group (including patients with GH, preeclampsia, and eclampsia diagnosed) and 61 041 cases of non-GH group respectively. 3 ml of fasting venous blood was drawn during 14-19 weeks of pregnancy, and body weight, serum β-human chorionic gonadotropin (β-HCG), free estriol (uE3) and alpha fetal protein (AFP) were obtained through physical check and laboratory testing. β-HCG, AFP, uE3 were analyzed by using the corresponding median times of gestational age (MOM value), and multivariate logistic regression model and receiver operating characteristic curve (ROC curve) were used to analyze the predictive efficiency of serological indicators.

Results

Among 64 849 research subjects, the GH group (3 808 cases) and the non-GH group (61 041) were (29.51±2.72), (29.38±2.68) years old, the weights were (65.46±12.17), (58.73±9.13) kg, gestational age of blood collection were (16.53±0.89) and (16.58±0.90) weeks respectively. The analysis of multivariate logistic regression model showed that the risk of GH increased with the increase of body weight, β-HCG and AFP concentration, OR (95%CI) values were 1.059 (1.056-1.062), 1.329 (1.188-1.487) and 1.195 (1.125-1.269); so did when the concentration of uE3 decrease, OR (95%CI) value was 0.527 (0.464-0.599). ROC curve analysis results show that age, weight, serum AFP, β-HCG, uE3 and multivariate diagnosis all have predictive efficiency for GH (P values<0.05); combined diagnosis of multiple indicators and weight AUC (95%CI) were 0.684 (0.675-0.693) and 0.673 (0.663-0.682), but the Youden index, sensitivity, and specificity of the two were relatively small.

Conclusion

The β-HCG, AFP and uE3 of Down's screening in the second trimester of pregnancy were relatively low in predicting GH.