Relationship between echocardiography parameters and liver function during the second trimester of pregnancy and their predictive value for adverse pregnancy outcomes

doi:10.3877/cma.j.issn.2095-2015.2023.06.028

Abstract

Abstract:

Objective

To explore the correlation between echocardiography parameters and liver function during the second trimester of pregnancy, and their predictive value for adverse pregnancy outcomes.

Methods

A retrospective analysis was conducted on 200 pregnant women who underwent regular prenatal examinations and gave birth between January 2021 and January 2023 at Minhang Central Hospital.These women were divided into two groups based on their pregnancy outcomes: the non-adverse pregnancy outcome group(n=108)and the adverse pregnancy outcome group(n=92). The baseline data, echocardiography parameters during the second trimester [left ventricular posterior wall thickness in diastole(LVPWd), left ventricular end-systolic diameter, (LVESd), left ventricular end-diastolic diameter(LVEDd), interventricular septal thickness in diastole(IVSd), left ventricular ejection fraction(LVEF), left atrial diameter(LAD), peak blood flow velocity in early mitral orifice diastole/peak blood flow velocity in late mitral orifice diastole(E/A), E/mitral ring early peak diastolic velocity on the interventricular septal side and lateral wall(e′)], and liver function indicators [aspartate aminotransferase(AST), alanine aminotransferase(ALT), total bilirubin(TBIL). Pearson correlation analysis was used to assess the relationship between echocardiography parameters and liver function indicators during the second trimester, and ROC analysis was conducted to evaluate their predictive value for adverse pregnancy outcomes.

Results

The adverse pregnancy outcome group had significantly higher systolic blood pressure and diastolic blood pressure during the second trimester compared to the non-adverse outcome group(P<0.05), with a higher proportion of mild hypertension(P<0.05). The gestational age at delivery and birth weight of infants were also significantly lower in the adverse outcome group than those in the non-adverse outcome group(P<0.05). In terms of echocardiography parameters, the adverse pregnancy outcome group showed significantly higher values in LVPWd, LVESd, LVEDd, IVSd, LVEF, LAD, and E/e′ ratio, while the E/A ratio was significantly lower than that in the control group(P<0.05). Liver function indicators also showed significant elevations in the adverse outcome group(P<0.05). Pearson correlation analysis indicated a significant positive correlation between echocardiography parameters and liver function indicators in the adverse pregnancy outcome group.ROC analysis confirmed that echocardiography parameters and liver function indicators during the second trimester had a high predictive value for adverse pregnancy outcomes.

Conclusion

There is a significant positive correlation between echocardiography parameters and liver function indicators during the second trimester of pregnancy, and they have substantial predictive value for adverse pregnancy outcomes.

Key words: Second trimester of pregnancy, Adverse pregnancy outcomes, Echocardiography, Liver function, Correlation, Predictive value

Yuyan Zhang, Bin Hu, Weihong Zhang, Mei Xu, Hui Zhu, Xinyue Yang, Hailing Liu. Relationship between echocardiography parameters and liver function during the second trimester of pregnancy and their predictive value for adverse pregnancy outcomes[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2023, 13(06): 499-504.

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References 34

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组别	例数	孕妇一般基线资料						分娩信息
组别	例数	年龄(岁，±s)	孕周(周，max-min)	体重指数(kg/m²，±s)	孕次(次，max-min)	收缩压(mmHg，±s)	舒张压(mmHg，±s)	新生儿出生体重(g，±s)	胎龄(周，max-min)
非不良妊娠结局组	108	29.35±2.14	21.00(14.00~28.00)	26.80±1.73	2.00(1.00~3.00)	118.30±7.12	75.36±6.37	3265.31±402.60	38.50(37.00~40.00)
不良妊娠结局组	92	28.92±2.32	21.00(14.00~28.00)	27.25±1.86	2.00(1.00~3.00)	136.39±9.61	88.27±8.01	2818.20±528.20	37.50(35.00~40.00)
t		1.362	0.494	1.771	0.171	15.26	12.69	6.784	2.308
P		0.175	0.621	0.078	0.864	<0.001	<0.001	<0.001	0.023

组别	例数	孕妇一般基线资料						分娩信息
组别	例数	年龄(岁，±s)	孕周(周，max-min)	体重指数(kg/m²，±s)	孕次(次，max-min)	收缩压(mmHg，±s)	舒张压(mmHg，±s)	新生儿出生体重(g，±s)	胎龄(周，max-min)
非不良妊娠结局组	108	29.35±2.14	21.00(14.00~28.00)	26.80±1.73	2.00(1.00~3.00)	118.30±7.12	75.36±6.37	3265.31±402.60	38.50(37.00~40.00)
不良妊娠结局组	92	28.92±2.32	21.00(14.00~28.00)	27.25±1.86	2.00(1.00~3.00)	136.39±9.61	88.27±8.01	2818.20±528.20	37.50(35.00~40.00)
t		1.362	0.494	1.771	0.171	15.26	12.69	6.784	2.308
P		0.175	0.621	0.078	0.864	<0.001	<0.001	<0.001	0.023

组别	例数	LVPWd(mm)	LVESd(mm)	LVEDd(mm)	IVSd(mm)	LVEF(%)
非不良妊娠结局组	108	8.74±1.22	28.94±1.15	45.16±1.25	8.52±0.79	60.72±3.81
不良妊娠结局组	92	9.80±1.78	31.45±1.92	51.25±3.71	9.92±1.38	57.31±4.45
t/χ²		4.97	11.40	16.03	8.96	5.84
P		<0.001	<0.001	<0.001	<0.001	<0.001
组别	例数	LAD(mm)	E/A	E/e′	e′(cm/s)	左心室肥厚[例(%)]
非不良妊娠结局组	108	30.25±1.66	1.38±0.25	6.26±0.80	10.02±1.55	0
不良妊娠结局组	92	38.12±2.40	1.02±0.35	10.32±2.07	8.68±1.56	31(33.70)
t/χ²		27.27	8.46	18.81	6.08	43.07
P		<0.001	<0.001	<0.001	<0.001	<0.001

组别	例数	LVPWd(mm)	LVESd(mm)	LVEDd(mm)	IVSd(mm)	LVEF(%)
非不良妊娠结局组	108	8.74±1.22	28.94±1.15	45.16±1.25	8.52±0.79	60.72±3.81
不良妊娠结局组	92	9.80±1.78	31.45±1.92	51.25±3.71	9.92±1.38	57.31±4.45
t/χ²		4.97	11.40	16.03	8.96	5.84
P		<0.001	<0.001	<0.001	<0.001	<0.001
组别	例数	LAD(mm)	E/A	E/e′	e′(cm/s)	左心室肥厚[例(%)]
非不良妊娠结局组	108	30.25±1.66	1.38±0.25	6.26±0.80	10.02±1.55	0
不良妊娠结局组	92	38.12±2.40	1.02±0.35	10.32±2.07	8.68±1.56	31(33.70)
t/χ²		27.27	8.46	18.81	6.08	43.07
P		<0.001	<0.001	<0.001	<0.001	<0.001

组别	例数	谷草转氨酶(U/L，±s)	谷丙转氨酶(U/L，±s)	总胆红素(μmol/L，±s)	肝功能指标异常[例(%)]
非不良妊娠结局组	108	29.18±4.46	36.35±6.10	17.45±1.12	10(9.26)
不良妊娠结局组	92	38.30±6.84	45.45±8.73	20.45±3.80	43(46.73)
t/χ²		11.32	8.638	7.82	35.83
P		<0.001	<0.001	<0.001	<0.001

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