| ObjectiveIn this study,we examined the levels of STAT4 and STAT6 in maternal peripheral serum,umbilical cord serum and placental tissues of the subjects to explore the role of STAT4 and STAT6 in the occurrence and development of preeclampsia(PE),and further analyzed the levels of STAT4 and STAT6 and maternal and infant adverse pregnancy knots.This study aims to provide new theoretical basis and approaches for disease prediction,early prevention and treatment,and improvement of maternal and fetal pregnancy outcomes.Methods1.From December 2016 to June 2018,87 pregnant women admitted to the Obstetrics Department of Subei Hospital were selected,including 42 normal pregnant women(normal control group)and 45 preeclampsia patients(preeclampsia group).Inclusion criteria of this study:All the selected cases were single pregnancies.There were no history of heart disease,hypertension,diabetes mellitus,liver and kidney disease,endocrine and metabolic diseases,no autoimmune diseases such as rheumatism,rheumatoid,systemic lupus erythematosus,no infection,inflammation and other medical complications.The basic data of the subjects were collected and sorted out,including delivery age,times of pregnancy and delivery,gestational weeks of delivery,blood pressure,birth weight,length,Apgar score and maternal and infant pregnancy outcomes such as liver and kidney function damage,placental abruption,postpartum hemorrhage,premature delivery,neonatal asphyxia,neonatal pneumonia,etc.2.Determine the level of STAT4 and STAT6 for all studied groups maternal blood plasma?cord blood plasma with enzyme linked immunoassay assay(ELISA).3.Determine the level of STAT4 and STAT6 for all studied groups placental tissue with Immunohistochemistry(IHC).4.According to the expression level of STAT4 and STAT6 in maternal blood,umbilical cord blood and placenta of pregnant women,the receiver operating characteristic curve(ROC curve)was drawn,and the optimal diagnostic threshold was selected.5.According to the adverse pregnancy outcomes of pregnant women and newborns,it can be divided into two subgroups(good pregnancy outcomes group and bad pregnancy outcomes group),compared the expression levels of STAT4 and STAT6 in maternal serum,umbilical cord serum and placental tissue of the two groups.Results1.Comparison of general clinical data:(1)Compared with the normal control group,the gestational weeks of preeclampsia group was significantly smaller,but systolic and diastolic blood pressure were significantly higher(P<0.05).There was no significant difference in age,number of pregnancies and prenatal BMI between the two groups(P>0.05).(2)Compared with the normal control group,the weight,length and PI index of neonates in preeclampsia group were significantly smaller(P<0.05).There was no significant difference in Apgar score between the two groups(P>0.05).2.The results of ELISA were as follows:(1)The concentration of STAT4 in serum of pregnant women in normal control group and preeclampsia group were 144.02±32.56pg/mL and 207.03±54.61pg/mL,respectively.The concentration of STAT4 in umbilical cord serum were 68.82±22.55pg/mL and 126.18±39.06 pg/mL,respectively,with statistical significance(P<0.05).(2)The concentration of STAT6 in serum of pregnant women in normal control group and preeclampsia group were 245.32 ±48.60pg/mL and 142.00±47.01 pg/mL,respectively.The concentration of STAT6 in umbilical cord serum were were 200.35±52.61 pg/mL and 92.36±45.79pg/mL,respectively,with statistical significance(P<0.05).3.The results of Immunohistochemical were as follows:(1)STAT4 and STAT6 positive cells were mainly expressed in syncytiotrophoblast cytoplasm and stromal cell cytoplasm in decidua,and the positive expression was yellow or brown.(2)The MOD values of STAT4 in placenta of preeclampsia and normal control group were 0.04338±0.01281 and 0.01790±0.00589,respectively.The level of STAT4 in placenta of preeclampsia group was higher than that of normal control group(P<0.05).(3)The MOD values of STAT6 in placenta of preeclampsia and normal control group were 0.01504±0.00898 and 0.04731±0.01225,respectively.The level of STAT6 in placenta of preeclampsia group was lower than that of normal control group(P<0.05).4.Correlation analysis:Correlation analysis:STAT4 levels in maternal blood,umbilical cord blood and placenta were positively correlated(r=0.665,P=0.001;r=0.601,P=0.005;r=0.523,P=0.018).STAT6 levels in maternal blood,umbilical cord blood and placenta were positively correlated(r=0.599,P=0.005;r=0.627,P=0.003;r=0.546,P=0.013).STAT4 in maternal blood was negatively correlated with STAT6 expression level(r=-0.555,P=0.011),while STAT4 in umbilical cord blood was negatively correlated with STAT6 expression level(r=-0.433,P=0.031),and STAT4 in placenta was negatively correlated with STAT6 expression level(r=-0.588,P=0.006).5.The value of STAT4 and STAT6 in predicting preeclampsia:(1)STAT4 in maternal blood,umbilical cord blood and placenta was 0.771,0.844 and 0.954 respectively under ROC curve for diagnosis of preeclampsia.The cut-off values were 164.48pg/mL,94.43pg/mL and 0.02306,respectively.The levels of STAT4 in maternal and umbilical blood have certain accuracy in the diagnosis of pre-eclampsia,and the levels of STAT4 in placenta have higher accuracy in the diagnosis of pre-eclampsia.(2)STAT6 in maternal blood,umbilical cord blood and placenta was 0.852,0.895 and 0.967 respectively under ROC curve for diagnosis of preeclampsia.The cut-off values were 195.67pg/mL,166.65pg/mL and 0.03018,respectively.The levels of STAT6 in maternal and umbilical blood have certain accuracy in the diagnosis of pre-eclampsia,while the levels of STAT6 in placenta have higher accuracy in the diagnosis of pre-eclampsia.6.Comparisons of pregnancy outcomes:(1)Delivery mode:Compared with the normal control group,the cesarean section rate in preeclampsia group increased significantly(P<0.01).(2)Pregnancy outcome:The incidence of liver function damage in preeclampsia group was significantly higher than that in normal control group(P<0.05).There was no significant difference in renal function damage,thrombocytopenia,placental abruption,oligohydramnios,postpartum hemorrhage and postpartum fever between preeclampsia group and normal control group(P>0.05).(3)Neonatal outcome:The incidence of premature infants,low birth weight infants and fetal growth restriction in preeclampsia group was significantly higher than that in normal control group(P<0.05).The incidence of neonatal hypoglycemia,fetal distress,neonatal jaundice,neonatal hyaline membrane disease and neonatal pneumonia in preeclampsia group was not significantly different from that in normal control group(P>0.05).7.Relationship between STAT4 and STAT6 levels and adverse pregnancy outcomes in preeclampsia:(1)The expression level of STAT4 in maternal blood,umbilical cord blood and placenta of pregnant women with good pregnancy outcome was lower than that of pregnant women with poor pregnancy outcome(P<0.05).(2)The expression level of STAT6 in maternal blood,umbilical cord blood and placenta of pregnant women with good pregnancy outcomes was higher than that of those with poor pregnancy outcomes(P<0.05).Conclusion1.STAT4 was highly expressed in preeclampsia and STAT6 was low in preeclampsia.STAT4 and STAT6 may be related to the occurrence and development of preeclampsia.STAT4 and STAT6 levels may have certain significance and value in the prediction and diagnosis of preeclampsia.2.STAT4 was highly expressed in the group with poor pregnancy outcomes,while STAT6 was low in the group with poor pregnancy outcomes.STAT4 and STAT6 may be related to the occurrence of adverse pregnancy outcomes. |
PDF Full Text Request