BACKGROUND Preeclampsia(PE)substantially increases the risk of postpartum anxiety,yet limited research has examined how disease onset and clinical features,such as blood pressure control and body mass index(BMI)change...BACKGROUND Preeclampsia(PE)substantially increases the risk of postpartum anxiety,yet limited research has examined how disease onset and clinical features,such as blood pressure control and body mass index(BMI)changes during pregnancy,affect this risk.AIM To develop and apply a predictive model for postpartum anxiety disorder in patients with PE based on multidimensional indicators.METHODS A cross-sectional study was conducted among 196 patients with PE admitted to the Department of Obstetrics,Ninth People’s Hospital of Suzhou(Affiliated with Soochow University),from June 2019 to June 2024.According to the self-rating anxiety scale at six weeks postpartum,participants were divided into anxiety and no-anxiety groups.Two data sets were analyzed,and multivariate logistic regression was performed to identify risk and protective factors.Regression coefficients and constants were used to construct the predictive model.Model performance was evaluated using the receiver operating characteristic curve and area under the curve,along with a goodness-of-fit test.The model was then validated with clinical data.RESULTS Of the 196 patients with PE evaluated using the self-rating anxiety scale at six weeks postpartum,51(26.02%)patients showed anxiety symptoms.Significant group differences(P<0.05)were observed for blood pressure control,BMI increase,hematocrit(Hct),family relationships,and psychological resilience.Logistic regression indicated that,poor blood pressure control,greater BMI increase,elevated Hct levels,and strained family relationships during pregnancy were risk factors for postpartum anxiety in patients with PE(P<0.05),whereas higher psychological resilience was a protective factor(P<0.05).The prediction model was defined as:Logit(P)=0.684×pregnancy blood pressure control+0.805×pregnancy BMI increase+0.756×Hct+1.063×family relationship-1.105×psychological resilience score-5.487.The model’s area under the curve(0.908)exceeded that of individual indicators:Blood pressure control(0.794),BMI increase(0.814),Hct(0.808),family relationships(0.840),and psychological resilience(0.833).The goodness-of-fit test showed no overfitting(χ2=1.904,P=0.725).Clinical validation demonstrated sensitivity of 85.71%,specificity of 87.72%,and accuracy of 87.18%.CONCLUSION Postpartum anxiety risk in patients with PE is associated with poor blood pressure control,excessive BMI gain,elevated Hct index,and poor family relationships,while strong psychological resilience serve as a protective factor.The developed prediction model effectively supports clinical assessment and targeted management of postpartum anxiety in patients with PE.展开更多
Polycyclic aromatic hydrocarbons(PAHs)are widespread pollutants from incomplete combustion of organic materials,linked to various health issues and pregnancy complications.This study explored the relationship between ...Polycyclic aromatic hydrocarbons(PAHs)are widespread pollutants from incomplete combustion of organic materials,linked to various health issues and pregnancy complications.This study explored the relationship between PAH metabolites and gestational hypertension.Urine samples from 118 normal pregnant women and 40 with gestational hypertension were analyzed.In vitro experiments using human trophoblast cells(HTR-8/SVneo)exposed to these metabolites assessed their effects on cellular metabolism.Comprehensive metabolomics analysis was performed using Tidymass and DRomics to integrate global and dose-response metabolomics data.Results showed higher levels of 1-hydroxypyrene(1-OHPYR)and 9-Hydroxyphenanthrene(9-OHPHE)linked to gestational hypertension,inhibiting trophoblast cell invasion and migration.Identified markers include Isobutyryl-L-carnitine,methyl-3-hydroxybutyric acid,threonine,and glutamic acid for 1-OHPYR,and phosphocreatine for 9-OHPHE.This study highlights the connection between PAH metabolites and gestational hypertension,suggesting potential biomarkers and mechanisms.Future research should confirm these findings and explore prevention and treatment strategies.展开更多
目的探讨孕中期24 h动态血压监测(ABPM)早期预警子痫前期(PE)及不良妊娠转归的临床价值。方法随机选取2024年2月至2025年2月在南京医科大学第一附属医院孕中期产检首次发现诊间血压处于临界状态的单胎孕妇共81例,行24 h ABPM并追踪其妊...目的探讨孕中期24 h动态血压监测(ABPM)早期预警子痫前期(PE)及不良妊娠转归的临床价值。方法随机选取2024年2月至2025年2月在南京医科大学第一附属医院孕中期产检首次发现诊间血压处于临界状态的单胎孕妇共81例,行24 h ABPM并追踪其妊娠结局。根据是否并发PE分为正常组(49例)和PE组(32例),比较两组孕妇一般情况、24 h ABPM参数,应用logistic回归分析与PE预警相关的危险因素。同时,根据血压分型分为3组:杓型组(28例)、非杓型组(32例)和反杓型组(21例),分析昼夜血压波动与母儿转归的相关性。结果PE组首次发现血压处于临界状态时舒张压、随机尿蛋白阳性率均高于正常组(P<0.01),血压临界发现孕周显著早于正常组(P=0.001)。PE组24 h、白天、夜间平均收缩压和舒张压均显著高于正常组(P<0.01)。反杓型组和杓型组、非杓型组PE发生率分别为53.1%、12.5%和34.4%,三组间差异有统计学意义(χ2=22.899,P<0.01),且反杓型组PE发生率高于非杓型组和杓型组(P<0.017)。多因素logistic回归分析显示,首次发现血压临界状态的孕周早、门诊当天舒张压高、晨峰血压高和非杓型/反杓型血压是PE发生的独立预警因素(P<0.05)。杓型组、反杓型组和非杓型组分娩孕周、剖宫产率、胎儿生长受限(FGR)发生率差异有统计学意义(P<0.05),反杓型组分娩孕周低于杓型组(P<0.017),剖宫产率、FGR发生率高于杓型组;趋势χ2检验显示,随血压夜间较白昼下降程度降低(杓型→非杓型→反杓型),早产儿率呈显著升高趋势(linearχ2=5.245,P=0.022)。结论孕中期血压临界状态孕妇中,动态血压参数显著升高且血压昼夜节律紊乱。血压临界状态时孕周、门诊当天舒张压、晨峰血压和血压分型是PE发生的重要预警因素,且血压昼夜节律异常与剖宫产率、FGR等不良母儿转归密切相关。孕中期24 h ABPM可提供PE的预警及提示妊娠不良转归。展开更多
BACKGROUND Insomnia in patients with hypertensive disorders in pregnancy(HDP)appears closely associated with depression and anxiety,though this relationship requires further validation.AIM To examine the inter-relatio...BACKGROUND Insomnia in patients with hypertensive disorders in pregnancy(HDP)appears closely associated with depression and anxiety,though this relationship requires further validation.AIM To examine the inter-relationships among depression,anxiety,and insomnia in women with HDP.METHODS A total of 122 HDP cases were enrolled from January 2021 to January 2025.The Patient Health Questionnaire-9(PHQ-9)was used to evaluate depressive symptoms,while the Generalized Anxiety Disorder-7(GAD-7)assessed anxiety.Sleep duration,sleep efficiency,and insomnia were measured using the Pittsburgh Sleep Quality Index(PSQI).Spearman’s r determined inter-scale correlations.Deter-minants influencing depression and anxiety were identified via univariate and multivariate analyses.RESULTS Among the 122 women with HDP,20.49%exhibited depression and 24.59%had anxiety.The mean PHQ-9 and GAD-7 scores were 4.00(3.00,4.00)and 4.00(3.00,4.25),res-pectively.As pregnancy progressed,participants showed reduced sleep duration and efficiency,higher PSQI total scores,and an increased proportion of poor sleepers.Across all gestational stages,PHQ-9 and GAD-7 scores were positively correlated with PSQI results.Depression and anxiety were independently associated with a prior HDP history,limited spousal support,PSQI>5,and monthly income5,or monthly income<4000 yuan.展开更多
基金Supported by 2023 Academy-Level Research Start-Up Fund Project,No.YK202313.
摘要BACKGROUND Preeclampsia(PE)substantially increases the risk of postpartum anxiety,yet limited research has examined how disease onset and clinical features,such as blood pressure control and body mass index(BMI)changes during pregnancy,affect this risk.AIM To develop and apply a predictive model for postpartum anxiety disorder in patients with PE based on multidimensional indicators.METHODS A cross-sectional study was conducted among 196 patients with PE admitted to the Department of Obstetrics,Ninth People’s Hospital of Suzhou(Affiliated with Soochow University),from June 2019 to June 2024.According to the self-rating anxiety scale at six weeks postpartum,participants were divided into anxiety and no-anxiety groups.Two data sets were analyzed,and multivariate logistic regression was performed to identify risk and protective factors.Regression coefficients and constants were used to construct the predictive model.Model performance was evaluated using the receiver operating characteristic curve and area under the curve,along with a goodness-of-fit test.The model was then validated with clinical data.RESULTS Of the 196 patients with PE evaluated using the self-rating anxiety scale at six weeks postpartum,51(26.02%)patients showed anxiety symptoms.Significant group differences(P<0.05)were observed for blood pressure control,BMI increase,hematocrit(Hct),family relationships,and psychological resilience.Logistic regression indicated that,poor blood pressure control,greater BMI increase,elevated Hct levels,and strained family relationships during pregnancy were risk factors for postpartum anxiety in patients with PE(P<0.05),whereas higher psychological resilience was a protective factor(P<0.05).The prediction model was defined as:Logit(P)=0.684×pregnancy blood pressure control+0.805×pregnancy BMI increase+0.756×Hct+1.063×family relationship-1.105×psychological resilience score-5.487.The model’s area under the curve(0.908)exceeded that of individual indicators:Blood pressure control(0.794),BMI increase(0.814),Hct(0.808),family relationships(0.840),and psychological resilience(0.833).The goodness-of-fit test showed no overfitting(χ2=1.904,P=0.725).Clinical validation demonstrated sensitivity of 85.71%,specificity of 87.72%,and accuracy of 87.18%.CONCLUSION Postpartum anxiety risk in patients with PE is associated with poor blood pressure control,excessive BMI gain,elevated Hct index,and poor family relationships,while strong psychological resilience serve as a protective factor.The developed prediction model effectively supports clinical assessment and targeted management of postpartum anxiety in patients with PE.
基金supported by the National Key R&D Program of China(No.2018YFC1004304)Guangxi Natural Science Foundation General Project(No.2021GXNSFAA075027)the Open Research Fund of the National Health Commission Key Laboratory of Birth Defects Prevention&Henan Key Laboratory of Population Defects Prevention(No.ZD202201)。
摘要Polycyclic aromatic hydrocarbons(PAHs)are widespread pollutants from incomplete combustion of organic materials,linked to various health issues and pregnancy complications.This study explored the relationship between PAH metabolites and gestational hypertension.Urine samples from 118 normal pregnant women and 40 with gestational hypertension were analyzed.In vitro experiments using human trophoblast cells(HTR-8/SVneo)exposed to these metabolites assessed their effects on cellular metabolism.Comprehensive metabolomics analysis was performed using Tidymass and DRomics to integrate global and dose-response metabolomics data.Results showed higher levels of 1-hydroxypyrene(1-OHPYR)and 9-Hydroxyphenanthrene(9-OHPHE)linked to gestational hypertension,inhibiting trophoblast cell invasion and migration.Identified markers include Isobutyryl-L-carnitine,methyl-3-hydroxybutyric acid,threonine,and glutamic acid for 1-OHPYR,and phosphocreatine for 9-OHPHE.This study highlights the connection between PAH metabolites and gestational hypertension,suggesting potential biomarkers and mechanisms.Future research should confirm these findings and explore prevention and treatment strategies.
摘要目的探讨孕中期24 h动态血压监测(ABPM)早期预警子痫前期(PE)及不良妊娠转归的临床价值。方法随机选取2024年2月至2025年2月在南京医科大学第一附属医院孕中期产检首次发现诊间血压处于临界状态的单胎孕妇共81例,行24 h ABPM并追踪其妊娠结局。根据是否并发PE分为正常组(49例)和PE组(32例),比较两组孕妇一般情况、24 h ABPM参数,应用logistic回归分析与PE预警相关的危险因素。同时,根据血压分型分为3组:杓型组(28例)、非杓型组(32例)和反杓型组(21例),分析昼夜血压波动与母儿转归的相关性。结果PE组首次发现血压处于临界状态时舒张压、随机尿蛋白阳性率均高于正常组(P<0.01),血压临界发现孕周显著早于正常组(P=0.001)。PE组24 h、白天、夜间平均收缩压和舒张压均显著高于正常组(P<0.01)。反杓型组和杓型组、非杓型组PE发生率分别为53.1%、12.5%和34.4%,三组间差异有统计学意义(χ2=22.899,P<0.01),且反杓型组PE发生率高于非杓型组和杓型组(P<0.017)。多因素logistic回归分析显示,首次发现血压临界状态的孕周早、门诊当天舒张压高、晨峰血压高和非杓型/反杓型血压是PE发生的独立预警因素(P<0.05)。杓型组、反杓型组和非杓型组分娩孕周、剖宫产率、胎儿生长受限(FGR)发生率差异有统计学意义(P<0.05),反杓型组分娩孕周低于杓型组(P<0.017),剖宫产率、FGR发生率高于杓型组;趋势χ2检验显示,随血压夜间较白昼下降程度降低(杓型→非杓型→反杓型),早产儿率呈显著升高趋势(linearχ2=5.245,P=0.022)。结论孕中期血压临界状态孕妇中,动态血压参数显著升高且血压昼夜节律紊乱。血压临界状态时孕周、门诊当天舒张压、晨峰血压和血压分型是PE发生的重要预警因素,且血压昼夜节律异常与剖宫产率、FGR等不良母儿转归密切相关。孕中期24 h ABPM可提供PE的预警及提示妊娠不良转归。
基金Supported by Changzhou Health Commission Youth Science and Technology Projects,No.QN202218.
摘要BACKGROUND Insomnia in patients with hypertensive disorders in pregnancy(HDP)appears closely associated with depression and anxiety,though this relationship requires further validation.AIM To examine the inter-relationships among depression,anxiety,and insomnia in women with HDP.METHODS A total of 122 HDP cases were enrolled from January 2021 to January 2025.The Patient Health Questionnaire-9(PHQ-9)was used to evaluate depressive symptoms,while the Generalized Anxiety Disorder-7(GAD-7)assessed anxiety.Sleep duration,sleep efficiency,and insomnia were measured using the Pittsburgh Sleep Quality Index(PSQI).Spearman’s r determined inter-scale correlations.Deter-minants influencing depression and anxiety were identified via univariate and multivariate analyses.RESULTS Among the 122 women with HDP,20.49%exhibited depression and 24.59%had anxiety.The mean PHQ-9 and GAD-7 scores were 4.00(3.00,4.00)and 4.00(3.00,4.25),res-pectively.As pregnancy progressed,participants showed reduced sleep duration and efficiency,higher PSQI total scores,and an increased proportion of poor sleepers.Across all gestational stages,PHQ-9 and GAD-7 scores were positively correlated with PSQI results.Depression and anxiety were independently associated with a prior HDP history,limited spousal support,PSQI>5,and monthly income5,or monthly income<4000 yuan.