妊娠合并心脏病患者血清Gal-1、Gal-3、Gal-9与心功能分级和妊娠结局的关系OACSTPCD

Objective:To investigate the effects of serum levels of galectin-1(Gal-1),galectin-3(Gal-3),galectin-9(Gal-9)and cardiac function classification on pregnancy outcomes in pregnant patients with heart disease. Methods:A total of 163 pregnant women with heart disease admitted to Jiangyou People's Hospital from August 2019 to December 2022 were recruited as the study group,and 138 healthy pregnant women who underwent routine prenatal examination in Jiangyou People's Hospital during the same period were selected as the control group.According to the New York Heart Association(NYHA)classification,the study group was divided into Class Ⅰ group(n=41),Class Ⅱ group(n=66),Class Ⅲ group(n=30)and Class Ⅳ group(n=26 s).According to the incidence of adverse pregnancy outcomes in the study group,the enrolled patients were divided into a poor outcome group(n=25)and a good outcome group(n=138).Serum levels of Gal-1,Gal-3 and Gal-9 were detected,and pregnancy outcomes were tracked.Multivariate Logistic regression analysis was conducted to analyze the influencing factors of pregnancy outcomes in pregnant patients with heart disease.The value of serum Gal-1,Gal-3 and Gal-9 levels in predicting pregnancy outcomes in patients with pregnancy-related heart disease was analyzed by receiver operating characteristic(ROC)curve. Results:There were no significant differences in age and gestational age between the study group and the control group(P＞0.05).The serum Gal-1 and Gal-9 levels in the study group were significantly lower than those in the control group(P＜0.05),and the serum Gal-3 level was significantly higher than that in the control group(P＜0.05).The levels of serum Gal-1 and Gal-9 in grade Ⅳ group were significantly lower than those in grade Ⅰ,Grade Ⅱ and grade Ⅲ groups(P＜0.05),and the level of Gal-3 was significantly higher than that in grade Ⅰ,grade Ⅱ and grade Ⅲ groups(P＜0.05).There were 25 cases of adverse pregnancy outcomes in the study group.Serum Gal-1 and Gal-9 levels in the poor outcome group were significantly lower than those in the good outcome group(P＜0.05),and serum Gal-3 level was significantly higher than that in the good outcome group(P＜0.05).The results of multivariate analysis showed that NYHA grade Ⅲ to Ⅳ,grade Ⅴ to pregnancy risk and the high level of Gal-3 were risk factors for adverse pregnancy outcomes in pregnant women with heart disease(P＜0.05),and high serum levels of Gal-1 and Gal-9 were protective factors for pregnancy outcomes in pregnant women with heart disease(P＜0.05).The area under the curve of combining Gal-1,Gal-3 and Gal-9 levels to predict adverse pregnancy outcomes in pregnant women with heart disease was 0.865. Conclusions:The serum Gal-3 level increases while Gal-1 and Gal-9 levels decrease in pregnant women with heart disease,which is associated with the decreased cardiac function and the increased risk of adverse pregnancy outcomes.