Yiming Chen1,2, Yijie Chen3, Xue Wang4, Xuelian Chu5, Wenwen Ning3, Linyuan Gu5, Liyao Li6, Zhen Xie7, Caihe Wen7. 1. Department of Prenatal Diagnosis and Screening Center, Hangzhou Women's Hospital (Hangzhou Maternity and Child Health Care Hospital), No. 369, Kunpeng Road, Shangcheng District, Hangzhou, 310008, Zhejiang, China. cxy40344@163.com. 2. Department of the Fourth Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang, China. cxy40344@163.com. 3. Department of the Fourth Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang, China. 4. Nanjing Medical University, Nanjing, 210029, Jiangsu, China. 5. Department of Laboratory, Maternal and Child Health Hospital of Yuhang District, Hangzhou, 311100, Zhejiang, China. 6. Department of Prenatal Diagnosis and Screening Center, Hangzhou Women's Hospital (Hangzhou Maternity and Child Health Care Hospital), No. 369, Kunpeng Road, Shangcheng District, Hangzhou, 310008, Zhejiang, China. 7. Department of Obstetrics, Hangzhou Women's Hospital (Hangzhou Maternal and Child Health Care Hospital), Hangzhou, 310008, Zhejiang, China.
Abstract
BACKGROUND: This study investigated whether maternal serum D-dimer (DD) alone or DD combined with alpha-fetoprotein (AFP) and free β-subunit of human chorionic gonadotropin (free β-hCG) in the second trimester could be used to predict hypertensive disorders of pregnancy (HDP). MATERIALS AND METHODS: In this retrospective case-control study, the data of gravidas patients who delivered at hospital were divided into the following groups: control (n = 136), gestational hypertension (GH, n = 126), preeclampsia (PE, n = 53), and severe preeclampsia (SPE, n = 41). Receiver operator characteristic (ROC) curves were used to evaluate the diagnostic value of maternal serum DD, AFP, and free β-hCG levels for HDP. RESULTS: DD levels of the GH, PE, and SPE groups were significantly higher than that of the control group (P < 0.001). The order of effectiveness for models predicting HDP was as follows: DD + AFP + free β-hCG > DD > DD + AFP > DD + free β-hCG > AFP + free β-hCG > AFP > free β-hCG. For predicting different types of HDP, DD alone had the best diagnostic value for SPE, followed by PE and GH. DD alone had a sensitivity of 100% with a 0% false negative rate and had the highest positive likelihood ratio (+ LR) for SPE. DD alone in combination with AFP alone, free β-hCG alone and AFP + free β-hCG could reduce false positive rate and improve + LR. CONCLUSION: DD is possible the best individual predictive marker for predicting HDP. Levels of DD alone in the second trimester were positively correlated with the progression of elevated blood pressure in the third trimester, demonstrating the predicting the occurrence of HDP. The risk calculation model constructed with DD + free β-hCG + AFP had the greatest diagnostic value for SPE.
BACKGROUND: This study investigated whether maternal serum D-dimer (DD) alone or DD combined with alpha-fetoprotein (AFP) and free β-subunit of human chorionic gonadotropin (free β-hCG) in the second trimester could be used to predict hypertensive disorders of pregnancy (HDP). MATERIALS AND METHODS: In this retrospective case-control study, the data of gravidas patients who delivered at hospital were divided into the following groups: control (n = 136), gestational hypertension (GH, n = 126), preeclampsia (PE, n = 53), and severe preeclampsia (SPE, n = 41). Receiver operator characteristic (ROC) curves were used to evaluate the diagnostic value of maternal serum DD, AFP, and free β-hCG levels for HDP. RESULTS: DD levels of the GH, PE, and SPE groups were significantly higher than that of the control group (P < 0.001). The order of effectiveness for models predicting HDP was as follows: DD + AFP + free β-hCG > DD > DD + AFP > DD + free β-hCG > AFP + free β-hCG > AFP > free β-hCG. For predicting different types of HDP, DD alone had the best diagnostic value for SPE, followed by PE and GH. DD alone had a sensitivity of 100% with a 0% false negative rate and had the highest positive likelihood ratio (+ LR) for SPE. DD alone in combination with AFP alone, free β-hCG alone and AFP + free β-hCG could reduce false positive rate and improve + LR. CONCLUSION: DD is possible the best individual predictive marker for predicting HDP. Levels of DD alone in the second trimester were positively correlated with the progression of elevated blood pressure in the third trimester, demonstrating the predicting the occurrence of HDP. The risk calculation model constructed with DD + free β-hCG + AFP had the greatest diagnostic value for SPE.
Entities:
Keywords:
Alpha-fetoprotein; D-dimer; Free β subunit of human chorionic gonadotropin; Gestational hypertension; Hypertensive disorders of pregnancy; Preeclampsia
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