Abstract:Objective: To investigate correlation between serum levels of 25-hydroxyvitamin D (25OHD), fatty acid binding protein 4 (FABP4), and soluble vascular endothelial growth factor receptor-1 (sVEGFR-1) with disease progression of pregnant women with hypertensive disorders of pregnancy (HDP). Methods: From October 2022 to October 2023, 120 pregnant women with HDP in People's Hospital of Xinjiang Uygur Autonomous Region (study group) and 120 normal pregnant women (control group) were included. The patients in the study group were assigned into the gestational hypertension (GH) subgroup (n=79) and the pre-eclampsia (PE) subgroup (n=41) according to the disease progression. At admission, the levels of serum 25OHD, FABP4, and sVEGFR-1 were compared between the study group and the control group, and the levels of serum 25OHD, FABP4, and sVEGFR-1 and the incidence of adverse pregnancy outcome were compared between the two subgroups. The correlation between the levels of serum 25OHD, FABP4, and sVEGFR-1 at admission with the progression of GH to PE was assessed. The levels of serum 25OHD, FABP4, and sVEGFR-1 at admission were compared among patients with different pregnancy outcomes, and the values of the indexes in evaluating the progression of GH to PE and predicting adverse pregnancy outcomes were analyzed. Results: At admission, the study group had significantly lower serum 25OHD level, and higher levels of FABP4 and sVEGFR-1 than the control group (all P<0.05). PE subgroup had significantly lower serum 25OHD level and the incidence of adverse pregnancy outcomes, and higher levels of FABP4 and sVEGFR-1 than the GH subgroup (all P<0.05). Low serum 25OHD levels and high serum FABP4 and sVEGFR-1 levels at admission were independent risk factors for the progression of GH to PE (P<0.05). The total incidence of adverse pregnancy outcomes in the study group was 35.83% (43/120). At admission, the patients with poor pregnancy outcomes presented significantly lower serum 25OHD level, and higher levels of FABP4 and sVEGFR-1 than those with good pregnancy outcomes (P<0.05); the area under the curve (AUC) of the combined indicator in evaluating the progression of GH to PE at admission was significantly higher than that of 25OHD, FABP4, and sVEGFR-1 alone (0.937 vs 0.793, 0.813, 0.835; P<0.05); the AUC of the combined indicator in predicting adverse pregnancy outcomes of HDP patients was significantly higher than that of 25OHD, FABP4, and sVEGFR-1 alone (0.930 vs 0.810, 0.757, 0.772; P<0.05). Conclusion: The decreased serum 25OHD level and the increased serum FABP4 and sVEGFR-1 levels in HDP patients are independent risk factors for the progression of GH to PE. They have certain clinical value in evaluating the progression of GH to PE and predicting the risk of adverse pregnancy outcomes.
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