To assess the predictive value of uterine artery and left ventricular parameters for pre-eclampsia in women at 11-13⁺⁶ weeks of pregancy.

Pregnant women at 11-13⁺⁶ weeks of gestation who had their first prenatal examination at the Fourth Affiliated Hospital of Harbin Medical University from January 2020 to September 2022 were selected, and their clinical data were collected, including age, systolic blood pressure, diastolic blood pressure, mean arterial pressure (MAP), and other parameters.Ultrasound was applied to detect the uterine artery pulsatility index (PI), resistance index (RI), systolic/diastolic velocity ratio (S/D), left ventricular mean early diastolic mitral annular velocity (e'), mitral early diastolic peak velocity/mean early diastolic mitral annular velocity (E/e'), and other parameters. Pregnancy outcomes were recorded, based on which 108 cases of pre-eclampsia were identified, and 110 normal pregnant women were randomly selected as a control group. The t test or U test was used to compare the differences in the above parameters between the two groups. The independent influencing factors of pre-eclampsia were screened out by Logistic regression analysis, and a prediction model was constructed based on these factors. The accuracy of the prediction model was evaluated by receiver operating characteristic curve analysis, and the calibration curve was drawn to analyze the calibration degree of the prediction model.

Age [(30.07±5.03) vs (29.35±6.49)], systolic blood pressure [(111.75±5.20) mmHg vs (109.62±8.19) mmHg], diastolic blood pressure [(70.06±6.37) mmHg vs (68.62±6.35) mmHg], MAP [(82.30±7.54) mmHg vs (81.06±7.27) mmHg], uterine artery PI [(1.85±0.64) vs (1.64±0.57)], RI [(0.71±0.12) vs (0.69±0.11)], S/D [(4.33±1.64) vs (4.25±1.70)], and left ventricular E/e' [(8.32±0.91) vs (7.54±0.84)] of pregnant women in the pre-eclampsia group were significantly greater than those of the control group (t=0.923, 2.309, 1.601, 1.167, 2.441, 1.240, 0.937, and 6.301; P=0.034, 0.008, 0.010, 0.014, 0.005, 0.013, 0.025, and 0.001, respectively), while the e' [(9.81±1.74) vs (10.63±1.82)] of the left ventricle was smaller than that of the control group (t=3.256, P=0.002). Logistic regression analysis identified that MAP, uterine artery PI and RI, and left ventricular e' and E/e' were independent influencing factors of pre-eclampsia (odds ratio=1.08, 2.54, 1.56, 0.71, and 1.68; P=0.002, 0.004, 0.012, 0.004, and 0.013, respectively). The area under the curve of the nomogram model based on the above independent influencing factors for predicting pre-eclampsia was 0.81 (95% confidence interval: 0.75-0.87), with a sensitivity of 73.14% and specificity of 77.82%. The prediction model was well calibrated and had a high predictive accuracy for pre-eclampsia.

MAP, uterine artery PI and RI, and left ventricular e' and E/e' of pregnant women at 11-13⁺⁶ weeks of pregnancy have appreciated value for the prediction of pre-eclampsia. The nomogram model constructed based on MAP, uterine artery PI and RI, and left ventricular e' and E/e' of pregnant women in early pregnancy has good accuracy in predicting pre-eclampsia, is of great significance for the early management of patients with pre-eclampsia, and can improve the efficiency of clinical diagnosis.