摘要
Abstract
Objective:To investigate the factors for adverse pregnancy outcomes and the value of throm-boelastography(TEG)in patients with prethrombotic state(PTS)during pregnancy.Methods:A total of 183 preg-nant women with PTS treated at the Department of Obstetrics,Xiangya Third Hospital,Central South University,from January 2020 to September 2023 were retrospectively analyzed.These women were divided into two groups based on pregnancy outcomes:the favorable pregnancy outcome group(97 cases)and the adverse pregnancy outcome group(86 cases).The risk factors for adverse pregnancy outcomes were evaluated by univariate and multivariate analyses,and the diagnostic value of TEG was assessed using the receiver operating characteristic(ROC)curve and Kaplan-Meier method.Results:The results of univariate analysis indicated that,compared to-the favorable pregnancy outcome group,the positive rates of antinuclear antibody(ANA),anticardiolipin antibody(ACA),and anti-beta2 glycoprotein antibody 1(β2-GP1)were higher in the adverse pregnancy outcome group(P<0.05),and lower utilization rates of hydroxychloroquine and low-molecular heparin(P<0.05),and shorter clotting reaction time in the thromboelastography(TEG-R)(P<0.05).Multivariate Logistic regression analyses revealed that TEG-R,ANA,β2-GP1 and gestational age at treatment initiation were all independent risk factors for adverse pregnancy outcome in pregnant women with PTS during pregnancy(P<0.05).ROC curve analysis showed the area under the curve for TEG-R was 0.632(95%Cl 0.551-0.741).At a TEG-R value of 4.65 min,the specificity was 0.948 and the sensitivity was 0.302.Kaplan-Meier survival curve analysis revealed that the gesta-tional weeks of pregnant women with an TEG-R>4.65 min were significantly longer than those with an TEG-R≤4.65 min.These results were statistically significant(P<0.01).Conclusions:ANA,ACA,β2-GP1,and TEG are valuable for predicting and evaluating adverse pregnancy outcomes in PTS patients.The TEG-R value≤4.65 min may serve as a critical threshold to guid anticoagulant therapy during pregnancy.关键词
妊娠期血栓前状态/不良妊娠结局/影响因素/血栓弹力图Key words
Pregnant prethrombotic state/Adverse pregnancy outcomes/Influence factors/Thromboelastog-raphy分类
医药卫生
