Effects of magnesium sulfate combined with labetalol on vascular endothelial function and pregnancy outcomes in pregnant women with preeclampsia.

Objective: To investigate the effects of magnesium sulfate combined with labetalol treatment on vascular endothelial function and pregnancy outcomes in pregnant women with preeclampsia (PE).

Methods: In this retrospective study, clinical data was analyzed from 262 PE parturients who were treated in Xi'an High-Tech Hospital from January 2022 to February 2024. They were divided into the experimental group (138 cases) and the control group (124 cases) based on the treatment plan. The control group received magnesium sulfate monotherapy, while the experimental group received a combination of magnesium sulfate and labetalol. The therapeutic effect was evaluated by measuring changes in vascular endothelial function indicators such as nitric oxide (NO) and endothelin-1 (ET-1) levels, systolic blood pressure (SBP), and diastolic blood pressure (DBP). Adverse reactions and pregnancy outcomes were statistically analyzed.

Results: After treatment, the NO level was significantly higher while the ET-1 level was significantly lower in the experiment group than those in the control group (all P<0.001). The DBP and SBP in the experimental group were significantly lower than those in the control group (P=0.002 and P<0.001). Although the incidence of adverse reactions didn't differ significantly between the two groups (P=0.440), the incidence of adverse pregnancy outcomes in the experimental group was significantly lower than that in the control group (P=0.028). Multivariate logistic analysis showed that fasting blood sugar, gestational age, 24-hour urine protein, post-treatment NO, ET-1, DBP, and SBP are independent factors affecting adverse pregnancy outcomes, with higher gestational age and post-treatment NO levels being protective factors. The areas under the curve for fasting blood sugar, gestational age, urine protein, post-treatment NO, post-treatment ET-1, post-treatment DBP, and post-treatment SBP in predicting adverse pregnancy outcomes were 0.645, 0.598, 0.615, 0.654, 0.685, 0.669, and 0.673, respectively. Post-treatment NO was negatively correlated with fasting blood sugar, urine protein, post-treatment DBP, and post-treatment SBP (r=-0.713, r=-0.605, r=-0.650, r=-0.676, all P<0.001), and positively correlated with gestational age (r=0.626, P<0.001). Conversely, post-treatment ET-1 was positively correlated with fasting blood sugar, urine protein, post-treatment DBP, and post-treatment SBP (r=0.746, r=0.710, r=0.729, r=0.720, all P<0.001), and negatively correlated with gestational age (r=-0.753, P<0.001).

Conclusions: The combined treatment of magnesium sulfate and labetalol significantly improves vascular endothelial function and pregnancy outcomes in preeclamptic pregnant women, effectively controlling pregnancy hypertension and reducing the incidence of adverse pregnancy outcomes. This combined treatment is as safe as magnesium sulfate monotherapy and can be considered a preferred treatment plan for pregnant women with preeclampsia.