To explore the application value of six prediction models reported at home and abroad for adverse outcomes of hypertensive disorders of pregnancy(HDP) in eastern and western China.

For all patients who delivered in the First Affiliated Hospital of Soochow University and Sichuan Provincial Maternal and Child Health Care Hospital from May 1, 2011 to April 30, 2019 and were diagnosed with HDP, their clinical data were retrospectively analyzed. Six models, fullPIERS, miniPIERS, Zwertbroek, PREP, Ngwenya, and Ma Guojun, were used to predict the risk of adverse outcomes for the patients. The predictive performance of the models was evaluated in terms of discrimination and calibration.

A total of 2978 patients were eligible. Combined adverse outcomes occurred in 13.6% (405/2978) of women within 48 h of admission, and 22.0% (655/2978) at any time during admission. The delivery < 34 weeks (49.4%, 200/405), need for blood product transfusion (43.5%, 176/405), and placental abruption (23.5%, 95/405) were the most common adverse outcomes within 48 hours of admission. The area under of the curve of the six models for predicting adverse outcomes in the patients with HDP within 48 hours of admission/during hospitalization ranged from 0.600 to 0.897, the sensitivity ranged from 57.1% to 69.5%, and the specificity ranged from 60.1% to 76.6%. The Hosmer-Lemeshow test showed that except for the PREP model (which had a small validation population and was not evaluated for calibration), the P-values of all the other 5 models were less than 0.05.

The six prediction models have certain application value in the prediction of adverse outcomes of HDP patients in the eastern and western regions of China, but the fitting is poor. The predictors involved in some models are not routine inspection indicators, and the feasibility of large-scale model application is still open to question. It is still necessary to establish a better prognostic model suitable for local areas based on Chinese characteristics.

To analyze serum prolactin (PRL) levels during pregnancy in healthy single pregnant women of childbearing age in Suzhou, and to establish and verify the reference interval of serum PRL.

From January to March, 2022, the data of pregnant women with healthy single pregnancy at childbearing age were collected and prospectively followed up until delivery. According to the gestational age, the subjects were divided into early pregnancy group (less than 14 weeks), middle pregnancy group (14-27⁺⁶ weeks) and late pregnancy group (≥28 weeks). PRL was determined by Soling LIAISON XL automatic chemiluminescence immunoassay and LIAISON^® prolactin. After eliminating outliers, the medical reference interval of serum PRL during pregnancy was established by percentile method (P_2.5-P_97.5). In addition, 20 samples of healthy single pregnant women of childbearing age were randomly collected in early, middle and late pregnancy to verify the established reference interval. When no more than two PRL measurements in each group exceeded the established reference interval, they were considered validated.

A total of 170 participants were included in the early pregnancy group, 229 participants in the middle pregnancy group and 130 participants in the late pregnancy group. There were significant differences in serum PRL levels in pregnant women at different stages of pregnancy. With the increase of gestational age, serum PRL level increased. The reference intervals of serum PRL in early, middle and late pregnancy were 477-4270 mIU/L, 1060-6574 mIU/L and 3497-18 274 mIU/L, respectively. All the established reference intervals were verified.

This study has established the reference interval of serum PRL during pregnancy of healthy single pregnant women of childbearing age in Suzhou area, to provide help for clinical rational application of this index, and further reference for the prevention of pregnancy-related diseases.