Abstract
OBJECTIVE: To evaluate the clinical significance of combined detection of placental growth factor (PLGF), uterine artery pulse index (UTPI), and mean arterial pressure (MAP) in predicting preeclampsia (PE). METHODS: A total of 332 pregnant women who underwent regular prenatal check-ups at The Third Affiliated Hospital of Zunyi Medical University (The First People's Hospital of Zunyi) from January 2022 to December 2023 were retrospectively included in this study. Medical histories and laboratory examination data were collected. The participants were divided into a PE group and a normal group based on the occurrence of PE. Clinical data, including MAP, UTPI, and PLGF were recorded between 11 and 13(+6) weeks of pregnancy. A multivariate logistic regression analysis was performed with a significance level of P<0.05 to construct a predictive model for PE. The diagnostic efficacy of the combined MAP + UTPI + PLGF model for early pregnancy PE was assessed using ROC curves. In addition, 182 pregnant women who underwent regular prenatal check-ups in our hospital between February 1, 2023, and December 31, 2024, were selected for external verification. RESULTS: Multivariate logistic regression analysis identified age, body mass index (BMI), pregnancy associated plasma protein-A (PAPP-A), MAP, UTPI, and PLGF as independent predictors of early pregnancy PE (all P<0.05). The AUC values for age, BMI, PAPP-A, MAP, UTPI, and PLGF were 0.660, 0.669, 0.749, 0.869, 0.781, and 0.943, respectively. The AUC of the combined MAP + UTPI + PLGF model was 0.990 (95% CI: 0.938-0.998), with specificity and sensitivity values of 83.98% and 98.80% respectively. Internal validation showed a mean absolute error (MAE) of 0.012, and the consistency index was 0.99 (95% CI: 0.983-0.997). The AUC for external validation of the prediction model was 0.975 (95% CI 0.955-0.995, P<0.001). Bootstrap analysis (1000 repetitions) using the Hosmer-Lemeshow test showed a good model fit (χ(2)=4.039, P=0.854), with the slope of the calibration curve close to 1. CONCLUSION: Age, BMI, PAPP-A, MAP, UTPI, and PLGF were all effective predictors for early PE. Furthermore, the combined detection of high-risk factors (MAP, UTPI, PLGF) has a high predictive value for PE early in pregnancy.