Coagulation Index,PLGF And PAPP-A In Relation To Severe Preeclampsia

Objective: To explore whether coagulation-related indicators,placental growth factor(PLGF),and pregnancy-associated plasma protein-A(PAPP-A)are related to the occurrence of severe preeclampsia(SPE)and their clinical value in SPE screening.Methods: 91 pregnant women diagnosed with SPE in the Obstetrics Department of Chifeng College Affiliated Hospital from September 2019 to December 2022 were selected as the case group,and 100 randomly selected hospitalized normal pregnant women during the same period were selected as the control group.General information such as age,ethnicity,body mass index(BMI),gestational age at delivery,as well as clinical indicators including prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(FIB),platelets(PLT),PLGF,and PAPP-A were collected from both groups.SPSS 26.0 was used for statistical analysis.Results: 1.The BMI of the SPE group was greater than that of the normal pregnant group,and the gestational age at delivery of the SPE group was smaller than that of the normal pregnant group,both with statistical significance(P < 0.05).There was no statistical significance in age between the two groups(P > 0.05).Han and Mongolian were the main ethnic groups in both groups.2.In the early pregnancy,the PT,APTT,and PLGF of the SPE group were all lower than those of the normal pregnant group,and the TT of the SPE group was higher than that of the normal pregnant group,all with statistical significance(P < 0.05).There was no statistical significance in PAPP-A,PLT,and FIB(P >0.05).3.In the late pregnancy,the PT,APTT,and PLT of the SPE group were all lower than those of the normal pregnant group,and the TT of the SPE group was higher than that of the normal pregnant group,all with statistical significance(P < 0.05).There was no statistical significance in FIB(P > 0.05).4.In early pregnancy,a multi-index logistic model indicated that the greater the BMI and TT,and the shorter the PT,the greater the likelihood of developing SPE,with smaller gestational age at delivery.5.The AUCs of PT,TT,APTT,and PLGF in early pregnancy were 0.604,0.691,0.597,and 0.614,respectively,all with statistical significance(P < 0.05).The AUC of the multi-index logistic model was0.884,which was better than that of a single indicator for screening SPE.6.In the late pregnancy,the PT,APTT,and PLT were all lower than those in the early pregnancy,and the TT and FIB were higher than those in the early pregnancy,all with statistical significance(P < 0.05).Compared with the normal pregnant group,the difference in coagulation-related indicators between late pregnancy and early pregnancy was greater in the SPE group.Conclusion: 1)BMI,PT,APTT,TT,PLT,and PLGF may be independent influencing factors for the occurrence of severe preeclampsia.2)The combined index screening of severe preeclampsia in early pregnancy is more effective than single index screening.