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Abstract To study the value of the placental microvascular indexes and uterine artery blood flow parameters combined with serum microRNA (miR)-424 and miR-221 levels of pregnant women for predicting their fetal growth restriction (FGR). Methods: The clinical data of 163 pregnant women during the second trimester of pregnancy who had received prenatal examination and delivered in hospital from January 2020 to August 2022 were collected retrospectively. According to the absence or presence of FGR, these women were divided into group A (96 women with FGR) and group B (67 women without FGR). The pregnant women in the two groups were examined by color Doppler ultrasound during 14-21 gestational weeks. The uterine artery blood flow parameters, such as peak systolic to end-diastolic flow velocity ratio rate (S/D), pulsatile index (PI), and resistance index (RI), and the placental vascular indexes, such as vascularization index (VI), flow index (FI), and vascularization flow index (VFI) of the women in the two groups were obtained. The expression levels of serum miR-424 and miR-221 of the women were detected by quantitative real-time fluorescence PCR (qRT-PCR). Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of above indicators of the women for their FGR. Results: The VI and VFI values of the women in group A were significantly lower than those of the women in group B, and there was no significant difference in the FI value of the women between the two groups (P＞0.05). The S/D, PI and RI values of the women in group A were significantly higher than those of the women in group B, and the expression levels of serum miR-424 (0.29±0.14) and miR-221 (1.68±0.25) of the women in group A were significantly higher than those (0.13±0.07 and 1.02±0.20) of the women in group B (P<0.05). ROC curve analysis showed that the area under the curve (AUC) of the values of VI, VFI, S/D, PI, and RI, and the miR-424 and miR-221 levels of the women for diagnosing their FGR were 0.818, 0.856, 0.764, 0.679, 0.862, 0.793, and 0.856, respectively. The AUC, the sensitivity, and the specificity of the combination of the values of VI, VFI, S/D, PI, and RI, and the serum miR-424 and miR-221 levels of the women for diagnosing their FGR were 0.962, 91.0%, and 90.6%, respectively. The diagnostic value of the combination of the values of VI, VFI, S/D, PI, and RI, and the miR-424 and miR-221 levels of the women for diagnosing their FGR was significantly higher than that of the values of VI value, VFI value, S/D value, PI value, RI value, the miR-424 level, or miR-221 level alone. Conclusion: The combined detection of the uterine artery blood flow parameters, the placental vascular indexes, and the expression levels of serum miR-424 and miR-221 of the women for diagnosing their FGR occurrence has higher value, and which can be used as the effective indicators for clinical evaluating their maternal and infant prognosis.
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