Efficacy Analysis of Combined Prediction of Postpartum Hypertension by 24-hour Urinary Protein,Hematocrit-albumin,and BNP in Patients with Severe Preeclampsia at the End of Pregnancy
10.12259/j.issn.2095-610X.S20250221
- VernacularTitle:重度子痫前期患者妊娠末期24-hUP、HCT-ALB、BNP联合预测产后高血压的效能分析
- Author:
Xiaowei YANG
1
;
Yan WANG
;
Liqiong ZENG
;
Xuelian JIANG
Author Information
1. 重庆医科大学附属大学城医院妇产科,重庆 401331
- Keywords:
Severe preeclampsia;
End of pregnancy;
24-hUP;
Difference between hematocrit and plasma albumin;
Brain natriuretic peptide;
Postpartum hypertension;
Prediction
- From:
Journal of Kunming Medical University
2025;46(2):151-157
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the efficacy of combined prediction of postpartum hypertension using 24-h urinary protein quantification(24-hUP),hematocrit and plasma albumin difference(HCT-ALB),and brain natriuretic peptide(BNP)in patients with severe preeclampsia at the end of pregnancy.Methods A retrospective study was conducted using cluster sampling to select 540 patients with severe preeclampsia from the University City Hospital affiliated to Chongqing Medical University between January 2018 and December 2022.Patients were divided into a hypertension group(n=98)and a non-hypertension group(n=442)based on the occurrence of postpartum hypertension.Clinical data[age,body mass index(BMI),maternal type,abortion history,family history of hypertension,smoking history,total cholesterol(TC),triglyceride(TG),fasting blood glucose(FBG),systolic blood pressure(SBP),diastolic blood pressure(DBP)]and levels of 24-hour urinary protein excretion(UP),hematocrit-albumin(HCT-ALB),and BNP in the third trimester of pregnancy were compared between the two groups to analyze the predictive value of these indicators for postpartum hypertension.Results The levels of BMI,family history of hypertension,TC,TG,FBG,SBP and DBP in hypertensive group were higher than those in non-hypertensive group[(25.63±1.37)kg/m2 vs(23.05±1.23)kg/m2,70.41%vs 30.54%].(5.32±1.14)mmol/L vs(3.91±0.95)mmol/L,(3.48±0.82)mmol/L vs(1.66±0.43)mmol/L,(7.24±1.60)mmol/L vs(4.83±1.22)mmol/L,(148.27±13.29)mmHg vs(127.65±10.71)mmHg,(92.36±5.17)mmHg vs(84.20±4.35)mmHg],the difference was statistically significant(P<0.05).The levels of urinary protein,HCT,HCT-ALB and BNP at 24 h at the end of pregnancy in hypertension group were also higher than those in non-hypertension group[(7.82±2.18)g/24 h vs(6.15±1.26)g/24 h,(34.22±3.15)%vs(32.80±1.77)%].(6.19±2.01)vs(3.46±0.90),(646.43±170.59)pg/mL vs(523.81±134.62)pg/mL],while ALB level was lower than that of the non-hypertension group[(28.03±1.13)g/L vs(29.34±1.44)g/L],with statistically significant differences(P<0.05).There was a positive correlation between 24-hUP,HCT,HCT-ALB,BNP and SBP,DBP,while ALB was negatively correlated with SBP and DBP,the difference was statistically significant(P<0.05).24-hUP,HCT-ALB and BNP at the end of pregnancy were independent risk factors for postpartum hypertension,with a combined prediction AUC of 0.930(95%CI:0.905～0.950),a Jordon index of 0.719,sensitivity of 85.71%,the specificity of 86.20%.The AUC of the combined prediction was significantly greater than that of each individual predictor,with statistically significant differences(P<0.05).Conclusion 24-hUP,HCT-ALB,and BNP at the end of pregnancy are independent risk factors for postpartum hypertension.Their combined predictive efficacy is significantly superior to that of individual indicators and can be used as an optimal clinical method for predicting whether patients with severe preeclampsia will develop postpartum hypertension.
