Background:Research on fetal congenital heart defect(CHD)mostly focuses on etiology and mechanisms.However,studies on maternal complications or pathophysiology are limited.Our objective was to determine whether vascul...Background:Research on fetal congenital heart defect(CHD)mostly focuses on etiology and mechanisms.However,studies on maternal complications or pathophysiology are limited.Our objective was to determine whether vascular dysfunction exists in pregnant women carrying a fetus with congenital heart defects.Methods:We conducted a case-control study.27 cases of pregnant women carrying a fetus with major CHD admitted to our hospital for delivery between April 2021 and August 2022 were selected.Every case was matched with about 2 pregnant complication-free controls without fetal abnormalities.The proangiogenic and anti-angiogenic factors and pregnancy outcomes were compared.Results:The proangiogenic factors include vascular endothelial growth factor(VEGF)and placental growth factor(PlGF).The anti-angiogenic factors involve soluble fms-like tyrosine kinase 1(sFlt-1)and soluble endoglin(sEng).No differences were found in maternal plasma concentrations of PlGF,VEGF,and sFlt-1 between case-control groups when analyzed at 36 weeks≤gestational age(GA)<39 weeks and 39 weeks≤GA≤41 weeks.The concentrations of sEng in maternal plasma in the fetal CHD group were significantly higher than those in the control group:0.60(0.77)vs.0.32(0.26)ng/ml at 36 weeks≤GA<39 weeks,p=0.001 and 0.75(0.55)vs.0.28(0.27)ng/ml at 39 weeks≤GA≤41 weeks,p<0.001.Conclusion:Vascular dysfunction exists in pregnant women with fetal congenital heart defects,manifesting significantly elevated sEng concentration at delivery.展开更多
Objective:To investigate the correlation between maternal serum N-terminal pro-B-type natriuretic peptide(NT-proBNP)levels and gestational duration in pregnant women with pulmonary hypertension(PH).Methods:The study i...Objective:To investigate the correlation between maternal serum N-terminal pro-B-type natriuretic peptide(NT-proBNP)levels and gestational duration in pregnant women with pulmonary hypertension(PH).Methods:The study included pregnant individuals with PH stemming from mitral valve stenosis and mitral valve regurgitation(post-capillary PH)or pulmonary arterial hypertension(pre-capillary PH)who were admitted to Guangdong Provincial People’s Hospital between January 1,2014 and December 31,2020.In this retrospective cohort study,maternal serum NT-proBNP levels during pregnancy,along with other clinical data,were obtained from structured electronic medical records.These data included gestational age at delivery,echocardiographic parameters,laboratory findings,gestational duration,delivery mode,and other relevant clinical variables.Univariate and multivariate regression analyses were conducted to assess the association between NT-proBNP levels and gestational duration.Adjustments were made for potential confounding factors,and curve fitting and threshold effect analysis were employed to identify tangent points.Furthermore,stratified analyses were performed based on tricuspid regurgitation velocity,maternal age,and parity.Results:A total of 64 patients with post-capillary PH and 74 patients with pre-capillary PH were included in this study.Among patients with post-capillary PH,the results of multivariate regression analysis indicated a significant association between maternal NT-proBNP levels and gestational duration(β=-0.03,95%confidence interval(CI)-0.05 to 0.00,P=0.02).The fitted curve demonstrated a negative correlation between maternal NT-proBNP levels and gestational duration,with a significant break point at 379.9 ng/L(P<0.05).In the post-capillary PH group,the stratified analysis revealed a regression coefficient of-0.05(95%CI:-0.06 to-0.04,P=0.001)in patients with a tricuspid regurgitation velocity>340 mm/s.For patients>35 years old,the regression coefficient was-0.03(95%CI-0.06 to-0.01,P=0.02).In multiparous women,the regression coefficient was-0.03(95%CI-0.06 to 0.00,P=0.03).Conclusion:In pregnant women with pulmonary hypertension,maternal NT-proBNP levels are associated with gestational duration,particularly with an increased risk of preterm labor.展开更多
基金supported by grants from the Guangzhou Municipal Science and Technology Bureau(Nos.202102080466,202201011423,202206010049,2023B03J0596,2023B03J1254,2023B03J1255)Department of Science and Technology of Guangdong Province(Nos.2020B1111170011,2023A1515012501)+1 种基金the Natural Science Foundation of Guangdong Province(Nos.2023A1515010801,2021A1515011445)the National Natural Science Foundation of China(Nos.82100371,81903287).
文摘Background:Research on fetal congenital heart defect(CHD)mostly focuses on etiology and mechanisms.However,studies on maternal complications or pathophysiology are limited.Our objective was to determine whether vascular dysfunction exists in pregnant women carrying a fetus with congenital heart defects.Methods:We conducted a case-control study.27 cases of pregnant women carrying a fetus with major CHD admitted to our hospital for delivery between April 2021 and August 2022 were selected.Every case was matched with about 2 pregnant complication-free controls without fetal abnormalities.The proangiogenic and anti-angiogenic factors and pregnancy outcomes were compared.Results:The proangiogenic factors include vascular endothelial growth factor(VEGF)and placental growth factor(PlGF).The anti-angiogenic factors involve soluble fms-like tyrosine kinase 1(sFlt-1)and soluble endoglin(sEng).No differences were found in maternal plasma concentrations of PlGF,VEGF,and sFlt-1 between case-control groups when analyzed at 36 weeks≤gestational age(GA)<39 weeks and 39 weeks≤GA≤41 weeks.The concentrations of sEng in maternal plasma in the fetal CHD group were significantly higher than those in the control group:0.60(0.77)vs.0.32(0.26)ng/ml at 36 weeks≤GA<39 weeks,p=0.001 and 0.75(0.55)vs.0.28(0.27)ng/ml at 39 weeks≤GA≤41 weeks,p<0.001.Conclusion:Vascular dysfunction exists in pregnant women with fetal congenital heart defects,manifesting significantly elevated sEng concentration at delivery.
文摘Objective:To investigate the correlation between maternal serum N-terminal pro-B-type natriuretic peptide(NT-proBNP)levels and gestational duration in pregnant women with pulmonary hypertension(PH).Methods:The study included pregnant individuals with PH stemming from mitral valve stenosis and mitral valve regurgitation(post-capillary PH)or pulmonary arterial hypertension(pre-capillary PH)who were admitted to Guangdong Provincial People’s Hospital between January 1,2014 and December 31,2020.In this retrospective cohort study,maternal serum NT-proBNP levels during pregnancy,along with other clinical data,were obtained from structured electronic medical records.These data included gestational age at delivery,echocardiographic parameters,laboratory findings,gestational duration,delivery mode,and other relevant clinical variables.Univariate and multivariate regression analyses were conducted to assess the association between NT-proBNP levels and gestational duration.Adjustments were made for potential confounding factors,and curve fitting and threshold effect analysis were employed to identify tangent points.Furthermore,stratified analyses were performed based on tricuspid regurgitation velocity,maternal age,and parity.Results:A total of 64 patients with post-capillary PH and 74 patients with pre-capillary PH were included in this study.Among patients with post-capillary PH,the results of multivariate regression analysis indicated a significant association between maternal NT-proBNP levels and gestational duration(β=-0.03,95%confidence interval(CI)-0.05 to 0.00,P=0.02).The fitted curve demonstrated a negative correlation between maternal NT-proBNP levels and gestational duration,with a significant break point at 379.9 ng/L(P<0.05).In the post-capillary PH group,the stratified analysis revealed a regression coefficient of-0.05(95%CI:-0.06 to-0.04,P=0.001)in patients with a tricuspid regurgitation velocity>340 mm/s.For patients>35 years old,the regression coefficient was-0.03(95%CI-0.06 to-0.01,P=0.02).In multiparous women,the regression coefficient was-0.03(95%CI-0.06 to 0.00,P=0.03).Conclusion:In pregnant women with pulmonary hypertension,maternal NT-proBNP levels are associated with gestational duration,particularly with an increased risk of preterm labor.
