Objective To investigate the value of combined prediction of serum 25-hydroxyvitamin D 25-(OH)-D, homocysteine (Hcy) and brain natriuretic peptide (BNP) for pregnancy outcomes in patients with hypertensive disorders of pregnancy (HDP).

Methods A total of 200 patients with HDP were selected as research subjects and divided into gestational hypertension (GH) group (n=84), mild preeclampsia (PE) group (n=67) and severe PE group (n=49) according to the severity of the disease. Additionally, 50 healthy pregnant women were selected as control group. The serum levels of 25-(OH)-D, Hcy and BNP were compared among the groups, and their relationships with the severity of HDP were analyzed. According to the pregnancy outcomes of HDP patients, they were divided into poor pregnancy outcome group (n=82) and good pregnancy outcome group (n=118). The serum levels of 25-(OH)-D, Hcy and BNP were compared between the poor and good pregnancy outcome groups. Logistic regression analysis was used to screen for the influencing factors of poor pregnancy outcomes in HDP patients.

Results Compared with the control group, the severe PE group had the lowest serum 25-(OH)-D level, followed by the mild PE group and the GH group, with statistically significant differences (P < 0.001). Compared with the control group, the severe PE group had the highest serum Hcy and BNP levels, followed by the mild PE group and the GH group, with statistically significant differences (P < 0.001). Serum 25-(OH)-D was negatively correlated with the severity of HDP in patients (r=-0.427, P < 0.001), while serum Hcy and BNP were positively correlated with the severity of HDP in patients (r=0.585 and 0.682; P< 0.001). The serum 25-(OH)-D level in the poor pregnancy outcome group was significantly lower than that in the good pregnancy outcome group, while the serum Hcy and BNP levels were significantly higher than those in the good pregnancy outcome group (P < 0.05). Logistic regression analysis results showed that elevated serum Hcy and BNP levels, severe PE and elevated systolic blood pressure were independent risk factors for poor pregnancy outcomes in HDP patients, while high 25-(OH)-D level was a protective factor (P < 0.05). The area under the curve (AUC) of the prediction model constructed based on the Logistic regression analysis results was 0.911 (95%CI, 0.863 to 0.947), with asensitivity of 91.46% and specificity of 75.42%.

Conclusion As the severity of HDP in patients increases, their serum 25-(OH)-D level decreases, while serum Hcy and BNP levels increase. The combined prediction of serum 25-(OH)-D, Hcy and BNP has a high value for predicting poor pregnancy outcomes in HDP patients.