Pathogens, risk factors for puerperal infections and expressions of PI3K and Akt in placental tissues of pregnant women with pregnancy-induced hypertension

OBJECTIVE To explore the distribution of pathogens, risk factors for puerperal infections and expressions of phosphatidylinositol-3 kinase (PI3K) and protein kinase B (Akt) in placental tissues of the pregnant women with pregnancy-induced hypertension. METHODS A total of 76 pregnant women with pregnancy-induced hypertension who were treated in obstetrics and gynecology department of Lishui Hospital of TCM from Aug 2016 to Aug 2021 were enrolled in the study, the clinical data of the subjects were retrospectively analyzed. The subjects were divided into the infection group with 26 cases and the non-infection group with 40 cases according to the status of puerperal infection. The clinical data were compared between the two groups, the risk factors for the puerperal infections and their association with the expressions of placental tissue PI3K and Akt were observed. RESULTS The pregnant women with pregnancy-induced hypertension who had cesarean section, postpartum massive hemorrhage, labor stage more than 8 hours, premature rupture of membrane, gestational diabetes mellitus and antenatal anemia were more likely to have puerperal infections (P<0.05). The postpartum massive hemorrhage and labor stage were the risk factors for the puerperal infections(P<0.05). The expression levels of PI3K, Akt and mammalian target of rapamycin (mTOR) of the infection group were lower than those of the non-infection group (P<0.05); the levels of microtubule-associated protein 1 light chain 3-Ⅱ (LC3-Ⅱ), autophagy 7 (Atg7), interleukin (IL)-6, IL-8 and C-reactive protein (CRP) of the infection group were significantly higher than those of the non-infection group (P<0.05). The sensitivity of the PI3K was 88.46% in prediction of the postpartum puerperal infections, with the specificity 85.00%; the sensitivity of the Akt was 88.46% in prediction of the postpartum puerperal infections, with the specificity 87.50%; the sensitivity of the mTOR was 92.31% in prediction of the postpartum puerperal infections, with the specificity 92.50%. CONCLUSION Labor process and postpartum massive hemorrhage are the risk factors for the puerperal infections in the pregnant women with pregnancy-induced hypertension. The placental tissue PI3K and Akt can predict the risk of the infections.