To investigate the predictive values of the levels of serum placental growth factor (PLGF), γ-interferon induced protein 16 (IFI16), and angiopoietin like protein 2 (ANGPTL2) of pregnant women with hypertensive disorders of pregnancy (HDP) for their adverse pregnancy outcomes. Methods: A total of 126 pregnant women with HDP who visited to hospital and gave birth from January 2020 to January 2023 were selected in this study. These women were divided into group A1 (58 cases with mild HDP) and group A2 (68 cases with severe HDP) based on the severity of their HDP. According to the pregnancy outcomes of follow-up, these women were divided into group B1 (52 cases with adverse pregnancy outcomes) and group B2 (74 cases with normal pregnancy outcomes). 60 healthy pregnant women who gave birth in hospital were included in control group. The levels of the serum triglycerides (TG), total cholesterol (TC) and glycated hemoglobin (HbA1c), and the levels of the 24-hour urine protein and uric acid (UA) and the creatinine (Cr) in urine of the women in these groups were detected. Spearman correlation analysis was used to analyze the correlation between the levels of the PLGF, IFI16, Angptl2 of the women with HDP and their severity of
HDP and pregnancy outcomes. Logistic regression was used to analyze the influencing factors of the adverse pregnancy outcomes of the women. Receiver operator characteristic (ROC) curve was used to analyze the predictive values of the PLGF, IFI16 and ANGPTL2 levels of the women with HDP for predicting their adverse pregnancy outcomes. Results: The serum PLGF level of the women in the control group, in group A1 and in group A2 had decreased gradually, while the IFI16 and ANGPTL2 level had increased gradually. The values of diastolic blood pressure and systolic blood pressure, and the levels of 24 h urinary protein, IFI16 and ANGPTL2 of the women in group B2 were significantly lower than those in group B1, the PLGF level of the women in group B2 was significantly higher (all P<0.05). The severity of HDP and the adverse pregnancy outcomes of the women were negatively correlated with their PLGF level, and were positively correlated with their IFI16 and ANGPTL2 levels (P<0.05). The abnormal increase of the diastolic blood pressure and systolic blood pressure values, and the IFI16 and ANGPTL2 levels of the women with HDP were the risk factors of their adverse pregnancy outcomes, and the increase of the PLGF level of the women was a protective factor of their adverse pregnancy outcomes (P<0.05). The area under the curve, the sensitivity and the specificity of the combined detections of the PLGF, IFI16, and ANGPTL2 levels of the women with HDP for predicting their adverse pregnancy outcomes were 0.905, 98.1% and 73.0%, respectively, and which were significantly higher than those of the PLGF level, the IFI16 level or the ANGPTL2 level alone (P<0.05). Conclusion: The serum PLGF level of the pregnant women with HDP is low, and the serum IFI16 and ANGPTL2 of them are high. The combination detections of the PLGF, IFI16, and ANGPTL2 levels of the pregnant women with HDP can improve the predictive value for their adverse pregnancy outcomes.