Predictive value of PAPP-A,fE3 and β-hCG analyzed by ROC curve on preeclampsia

Objective:To explore the predictive value of pregnancy-associated plasma protein A(PAPP-A),free estriol(fE3) and β-human choionic gonadotophin(β-hCG) on preeclampsia.Methods:A total of 117 pregnant women with pregnancy-induced hypertension were divided into the preeclampsia group(49 cases) and pregnancy induced hypertension group(68 cases),and 90 healthy pregnant women were set as the control group.The serum levels of PAPP-A,fE3 and β-hCG in three groups during 15 to 20 weeks and 24 to 28 weeks of pregnancy were detected by enzyme linked immunosorbent assay,and the serum levels of PAPP-A,fE3 and β-hCG between three groups were compared.The receiver operating curve(ROC) was drawn according to the serum levels of PAPP-A,fE3 and β-hCG,and the predictive value of PAPP-A,fE3 and β-hCG on preeclampsia was evaluated.Results:The differences of the age,parity and body mass index between three groups were not statistically significant(P>0.05),and the gestational weeks,neonatal birth weight and 1 minute Apgar scores in preeclampsia group were significantly lower than those in pregnancy induced hypertension group and control group(P<0.05).During the 15 to 20 weeks of pregnancy,the differences of the serum levels of PAPP-A,fE3 and β-hCG between three groups were not statistically significant(P>0.05).During the 24 to 28 weeks of pregnancy,the serum levels of PAPP-A and fE3 in preeclampsia group were lower than those in pregnancy induced hypertension group and control group,and the serum level of β-hCG in preeclampsia group was higher than that in pregnancy induced hypertension group and control group(P<0.05).During the 24 to 28 weeks of pregnancy,the correlation analysis showed that serum level of PAPP-A was positively correlated with gestational age and neonatal birth weight(P<0.05 and P<0.01),the serum level of fE3 was positively correlated with gestational age(P<0.01),and the serum level of β-hCG was negatively correlated with neonatal 1 minute Apgar score(P<0.01).The prediction value of the combination of serum PAPP-A,fE3 and β-hCG was better than that of single index(P<0.05).The serum levels of PAPP-A,fE3,β-hCG,and combination detection had predictive value on preeclampsia(P<0.05).The area under the ROC curve of three indexes combination was the highest(0.857).Conclusions:In middle pregnancy of preeclampsia pregnant women,the serum levels of PAPP-A and fE3 decrease,and the level of β-hCG increases.During the 24 to 28 weeks of pregnancy,the combination detection of serum PAPP-A,fE3 and β-hCG can provide a basis for predicting preeclampsia.