Study On Risk Factors And Pregnancy Outcomes Of Preeclampsia Based On Maternal And Infant Health Cohort

Objective(s):1.Based on a prospective cohort study of maternal and infant health,describe and analyze the exposure of maternal clinical risk factors and the onset of maternal preeclampsia during pregnancy.2.Univariate and non-conditional logistic regression was used to analyze the relevant influencing factors of preeclampsia in this cohort population to explore the risk factors of preeclampsia.3.Establish a logistic regression prediction model for preeclampsia.4.Based on this healthy cohort,tracking the occurrence of adverse maternal and infant outcomes in PE and non-PE groups was studied to explore the impact of preeclampsia on pregnancy outcomes.Methods: Based on Qujing Maternal and Child Health Hospital of Yunnan Province,this study combined the data system of maternal pregnancy and newborns with the hospital electronic medical record system through the unique identification number to form a prospective cohort of maternal and infant health.In this study,maternal women who joined the cohort study and had delivery outcome during the period from January1,2021 to June 30,2022 were selected as the study subjects.The study cohort was followed up information about prenatal,intrapartum,and postpartum,pregnancy outcomes,and neonatal information.if incomplete information,the missing information was tracked through the ID identification number,to ensure the relative integrity of the research object information.According to pre-eclampsia,pregnant women were divided into PE group and non-PE group,maternal characteristics and clinical related information of the two groups adopts t-test or chi-square test,logistic regression to explore risk factors of pre-eclampsia,and establish a logistic regression model,the ROC curve was used to evaluate the predictive ability of the prediction model.At the same time,based on this maternal and infant health cohort,we tracked the information on maternal and infant outcomes such as delivery mode,postpartum hemorrhage,and premature birth,compared the occurrence of adverse pregnancy outcomes between the two groups,and analyzed the impact of pre-eclampsia on pregnancy outcomes.Results:(1)A total of 11,736 pregnant women were included in this study analysis,among which 159 pregnant women had pre-eclampsia,with an incidence rate of preeclampsia of 1.35%.(2)The results of multivariate analysis showed that polycystic ovary syndrome(OR = 1.170,95%CI: 1.227～8.455),pulmonary arterial hypertension(OR = 2.483,95%CI: 1.128 to 5.466),diabetes mellitus in pregnancy(OR = 1.745,95%CI: 1.055 to 2.866),hypertension in pregnancy(OR = 64.435,95%CI:41.468～100.120)were all risk factors for pre-eclampsia;The number of prenatal examinations> 8(OR = 0.605,95%CI: 0.401～0.913)and college education or above(OR = 0.517,95%CI: 0.290～0.921)were protective factors;the risk prediction model of pre-eclampsia established from the results of logistic regression analysis is as follows: Y=-5.744+1.170(polycystic ovary syndrome)+ 0.909(pulmonary hypertension)+ 0.557(gestational diabetes mellitus)+ 4.166(gestational hypertension)-0.502(the number of prenatal examinations > 8)-0.660(education:college or above).The area under the ROC curve of pre-eclampsia predicted is 0.910(95%CI: 0.877～0.944),the sensitivity and specificity for predicting pre-eclampsia were 87.5% and 87.1%,the predictive efficacy of the model is better.(3)The incidence of preterm birth,low body weight infants,neonatal asphyxia,postpartum hemorrhage,and caesarean section were 37.11%、38.99%、12.66%、30.19% and81.13% respectively in the PE groups,and the incidence of the above outcome measures in the non-PE groups were 6.88%,6.21%,4.25%,26.15% and 40.21%,the difference between the two groups was statistically significant(P<0.05).Conclusion(s):(1)Polycystic ovary syndrome,pulmonary hypertension,gestational diabetes mellitus,gestational hypertension,the number of prenatal examinations>8,and college education or above were associated with the onset of preeclampsia;the area under ROC curve shows that the risk prediction model has good prediction ability,which can effectively predict and screen out the high-risk groups of preeclampsia,and is helpful to take corresponding intervention measures in clinic,so as to reduce the incidence of pre-eclampsia.(2)The incidence of various adverse pregnancy outcomes such as premature birth,postpartum hemorrhage,low body weight birth and neonatal asphyxia was higher in the PE group than that of the nonPE group,which seriously endangered the health of maternal and infant,so the prevention and prediction of preeclampsia should be strengthened to reduce its incidence.