联合孕中期BMI、血清游离β-HCG对妊娠期高血压疾病与妊娠期糖尿病发生的预测价值

Predictive Value of Second-Trimester BMI and Free β-HCG for Hypertensive Disorders of Pregnancy and Gestational Diabetes Mellitus

摘要: 目的：探究孕中期体重指数(BMI)、血清游离β-人绒毛膜促性腺激素(Free β-HCG)对妊娠期高血压疾病、妊娠期糖尿病发病的预测价值。方法：回顾性分析2023年1月至2023年12月于湖北民族大学附属民大医院规律产检并顺利分娩的300例孕妇的临床特征资料、孕中期母体血清游离β-HCG、AFP、uE3水平，分析不同指标与HDP、GDM的相关性，通过Logistic回归建立预测模型。结果：孕中期HDP组、GDM组的BMI、free β-HCG (MOM)水平均高于对照组，差异有统计学意义(P < 0.05)，均可作为HDP、GDM发生的独立危险因素，建立HDP预测模型ROC曲线下面积为0.82，95% CI (0.73~0.91)，区分度良好，具较高的预测价值，建立GDM风险预测模型，AUC为0.67，95% CI (0.60~0.73)，区分度一般，具有一定的预测价值。结论：孕中期BMI、血清Free β-HCG是HDP与GDM发生的独立危险因素，可纳入联合预测模型，对早期筛查、早期预防妊娠期并发症的发生具有较高价值。

Abstract: Objective: To investigate the predictive value of second-trimester BMI and serum free β-human chorionic gonadotropin (Free β-HCG) for the development of hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM). Methods: A retrospective analysis was conducted on 300 pregnant women who received regular prenatal care and had successful delivery at Minda Hospital Affiliated to Hubei Minzu University between January 2023 and December 2023. Clinical characteristics and maternal serum levels of free β-human chorionic gonadotropin (β-HCG), alpha-fetoprotein (AFP), and unconjugated estriol (uE3) in the second trimester were collected. The correlations of these parameters with hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM) were analyzed, and a predictive model was established using logistic regression. Results: BMI and Free β-HCG (MOM) levels in the HDP group and GDM group were significantly higher than those in the control group (P < 0.05), and both were independent risk factors for HDP and GDM. The area under the ROC curve (AUC) of the HDP prediction model was 0.82, with a 95% CI of 0.73~0.91, showing good discrimination and high predictive value. The AUC of the GDM risk prediction model was 0.67, with a 95% CI of 0.60~0.73, indicating moderate discrimination and certain predictive value. Conclusion: Second-trimester BMI and serum Free β-HCG are independent risk factors for HDP and GDM, and can be incorporated into a combined prediction model, which is valuable for the early screening and prevention of pregnancy complications.