Objective To detect the serum soluble endothelial factor(sEng)and placental protein 13(PP13)levels on fetal growth restriction(FGR)in patients with early-onset severe preeclampsia(EOSP)and toanalyze the predictive value.Methods A total of 138 EOSP patients admitted to the obstetrics and gynecology department of Department of Obstetrics,Handan Central Hospital from February 2022 to December 2023 were included as the eclampsia group.Patients with FGR were classified as the restricted group(n=72),while those without FGR were classified as the unrestricted group(n=66).49 healthy pregnant women who underwent physical examination at Department of Obstetrics,Handan Central Hospital were regarded as control group.The general information of the eclampsia group was collected and statistically analyzed.ELISA method was applied to detect sEng and PP13 in serum.Pearson correlation was applied to analyze the correlation between serum sEng,PP13 and neonatal weight.Logistic regression model was applied to analyze the influencing factors of FGR in EOSP patients.ROC curve was applied to analyze the value of serum sEng and PP13 in predicting FGR in EOSP patients.Results The serum sEng(39.03±4.02 ng/L)of the eclampsia group was higher than that of the control group(32.75±3.64 ng/L),and PP13(1.20±0.20 μg/L)was lower than that of the control group(1.69±0.28 μg/L),and the differences were statistically significant(t=9.622,13.182,all P<0.05).The systolic blood pressure(172.64±7.52 mmHg),diastolic blood pressure(109.56±3.29 mmHg),24-hour urine protein(1 951.08±210.16 mg/24 h),adverse maternal and infant outcomes(33.33%)and sEng(41.56±4.22 ng/L)in the restricted group were higher than those in the unrestricted group(166.72±5.11 mmHg,106.39±4.88 mmHg,1504.36±164.27 mg/24 h,12.12%,36.28±3.81 ng/L),and neonatal weight(1 864.07±191.33 g),PP13(1.08±0.13 μg/L)was lower than that in the unrestricted group(2437.94±257.81g,1.34±0.27 μg/L),and the differences were statistically significant(t=4.507～14.930,all P<0.05).Serum sEng was negatively correlated with neonatal weight(r=-0.532,P<0.001),while serum PP13 was positively correlated with neonatal weight(r=0.471,P<0.001).High systolic blood pressure,high diastolic blood pressure,high 24-hour urine protein,and high sEng were risk factors for FGR in EOSP patients,while high PP13 was a protective factor(Wald χ2=4.731～129.166,all P<0.05).The AUC(95%CI)predicted by combined detection of serum sEng and PP13 was higher than AUC(95%CI)predicted by single detection and the differences were statistically significant(Z=2.790,3.443,all P<0.05).Conclusion EOSP patients with FGR have higher serum sEng level and lower PP13 level.sEng and PP13 are influencing factors for FGR in EOSP patients.Combined detection can improve the clinical value of predicting FGR in EOSP patients.

Objective To detect the serum soluble endothelial factor(sEng)and placental protein 13(PP13)levels on fetal growth restriction(FGR)in patients with early-onset severe preeclampsia(EOSP)and toanalyze the predictive value.Methods A total of 138 EOSP patients admitted to the obstetrics and gynecology department of Department of Obstetrics,Handan Central Hospital from February 2022 to December 2023 were included as the eclampsia group.Patients with FGR were classified as the restricted group(n=72),while those without FGR were classified as the unrestricted group(n=66).49 healthy pregnant women who underwent physical examination at Department of Obstetrics,Handan Central Hospital were regarded as control group.The general information of the eclampsia group was collected and statistically analyzed.ELISA method was applied to detect sEng and PP13 in serum.Pearson correlation was applied to analyze the correlation between serum sEng,PP13 and neonatal weight.Logistic regression model was applied to analyze the influencing factors of FGR in EOSP patients.ROC curve was applied to analyze the value of serum sEng and PP13 in predicting FGR in EOSP patients.Results The serum sEng(39.03±4.02 ng/L)of the eclampsia group was higher than that of the control group(32.75±3.64 ng/L),and PP13(1.20±0.20 μg/L)was lower than that of the control group(1.69±0.28 μg/L),and the differences were statistically significant(t=9.622,13.182,all P<0.05).The systolic blood pressure(172.64±7.52 mmHg),diastolic blood pressure(109.56±3.29 mmHg),24-hour urine protein(1 951.08±210.16 mg/24 h),adverse maternal and infant outcomes(33.33%)and sEng(41.56±4.22 ng/L)in the restricted group were higher than those in the unrestricted group(166.72±5.11 mmHg,106.39±4.88 mmHg,1504.36±164.27 mg/24 h,12.12%,36.28±3.81 ng/L),and neonatal weight(1 864.07±191.33 g),PP13(1.08±0.13 μg/L)was lower than that in the unrestricted group(2437.94±257.81g,1.34±0.27 μg/L),and the differences were statistically significant(t=4.507～14.930,all P<0.05).Serum sEng was negatively correlated with neonatal weight(r=-0.532,P<0.001),while serum PP13 was positively correlated with neonatal weight(r=0.471,P<0.001).High systolic blood pressure,high diastolic blood pressure,high 24-hour urine protein,and high sEng were risk factors for FGR in EOSP patients,while high PP13 was a protective factor(Wald χ2=4.731～129.166,all P<0.05).The AUC(95%CI)predicted by combined detection of serum sEng and PP13 was higher than AUC(95%CI)predicted by single detection and the differences were statistically significant(Z=2.790,3.443,all P<0.05).Conclusion EOSP patients with FGR have higher serum sEng level and lower PP13 level.sEng and PP13 are influencing factors for FGR in EOSP patients.Combined detection can improve the clinical value of predicting FGR in EOSP patients.