Correlation Of Serum Cystatin C,Neutrophil/lymphocyte Ratio,Platelet/lymphocyte Ratio With The Severity Of Preeclampsia

Purpose:To study the correlation between cystatin C,neutrophil/lymphocyte ratio,platelet/lymphocyte ratio and the severity of preeclampsia.Methods:1.A retrospective selection of 278 PE patients who delivered in the Obstetrics Department of the First Affiliated Hospital of Shihezi University School of Medicine from January 2020 to August 2022 was used as the case group,including 116 cases in the mild PE group,162 cases in the severe PE group,and the same period 173 normal pregnant women of the same gestational age served as the control group.General data,clinical data and newborn clinical data of pregnant women were collected.2.The data was analyzed and processed by SPSS25.0,and the comparison of data between groups was performed usingχ~2test,variance analysis,and non-parametric rank sum test;Correlation analysis was performed using Spearman correlation;Risk factors were evaluated using Logistic regression,and ROC curve analysis was used to analyze related indicators diagnostic value.Results:1.Comparison of general information of pregnant women:Age,weight gain during pregnancy,weight control category during pregnancy,systolic and diastolic blood pressure at admission,pre-pregnancy body mass index(BMI),occupation,childbirth times,ethnicity,education level,and advanced age were statistically different(P<0.05);There was no statistical difference in pregnancy times among the three groups(P>0.05).2.Comparison of pregnancy serum indicators among the three groups of research objects:The platelet count,lymphocyte count,and PLR in the normal group were significantly higher than those in the mild PE group and severe PE group(P<0.05),and the difference was statistically significant;The neutrophil count in the severe PE group Cell count,NLR,Cys C were significantly higher than mild PE group,normal group(P<0.05),the difference was statistically significant.3.Correlation research between three groups of serum detection indexes and PE:Serum Cys C,NLR were positively correlated with systolic blood pressure,diastolic blood pressure,and 24-hour urine protein quantification(P<0.05);PLR was positively correlated with diastolic blood pressure,and 24-hour urine protein Negative correlation(P<0.05).Cys C,NLR were positively correlated with the severity of PE(P<0.05);PLR was negatively correlated with the severity of PE(P<0.05).Serum Cys C during pregnancy was positively correlated with NLR(r=0.453,P<0.05);Serum Cys C during pregnancy was negatively correlated with PLR(r=-0.421,P<0.05).4.Comparison of maternal and child outcomes among the three groups of research objects:The three groups of research objects have statistical differences in the gestational week of delivery,intraoperative or intrapartum hemorrhage,hospitalization days and expenses,newborn Apgar 1-minute and 5-minute scores,and newborn weight;There were statistically significant differences in the incidence rates of cesarean section,premature delivery,fetal growth restriction,premature rupture of membranes,abnormal amniotic fluid,neonatal asphyxia,low birth weight,and admission to the intensive care unit(NICU)among the three groups(P<0.05);There was no significant difference in the incidence of fetal distress and postpartum hemorrhage between the three groups(P>0.05).5.Correlation between serum detection indicators and maternal and infant outcomes:Serum Cys C is correlated with cesarean section,premature delivery,premature rupture of membranes,fetal growth restriction,abnormal amniotic fluid,low birth weight,and NICU admission(P<0.05),had no correlation with the occurrence of fetal distress,postpartum hemorrhage,and neonatal asphyxia(P>0.05);Serum NLR was correlated with the occurrence of cesarean section,premature delivery,premature rupture of membranes,low birth weight,and abnormal amniotic fluid(P<0.05),there is no correlation with fetal distress,fetal growth restriction,postpartum hemorrhage,neonatal asphyxia,and NICU admission(P>0.05);Serum PLR is correlated with cesarean section,premature delivery,and low birth weight(P<0.05),there was no correlation with fetal distress,fetal growth restriction,premature rupture of membranes,postpartum hemorrhage,abnormal amniotic fluid,neonatal asphyxia,and admission to NICU(P>0.05).6.Multivariate Logistic regression analysis of risk factors for PE:Increased serum Cys C,increased NLR,decreased PLR,pre-pregnancy BMI≥24.9kg/m~2,advanced age,primipara,unstable occupation,and abnormal weight control during pregnancy All were risk factors for PE(OR>1,P<0.05).7.The diagnostic value of Cys C,NLR and PLR to PE:The highest area under the ROC curve occurred with the combined factor(Cys C+NLR+PLR)diagnosis,followed by Cys C,NLR,and PLR(p<0.05).8.Correlation analysis between different groups of serum indicators and PE maternal and infant outcomes:There were statistical differences in the incidence of cesarean section,premature delivery,and low birth weight between groups with high and low levels of serum Cys C,NLR,and PLR(P<0.05).Conclusions:1.Serum Cys C and NLR during pregnancy were significantly positively correlated with the severity of PE,and PLR was significantly negatively correlated with the severity of PE.2.The increase of serum Cys C and NLR and the decrease of PLR during pregnancy have a certain correlation with the occurrence of cesarean section,premature delivery and low birth weight.3.The increase of serum Cys C and NLR and the decrease of PLR during pregnancy are risk factors for PE.