妊娠期糖脂代谢指标与胎儿窘迫的相关性研究

Relationship between gestational glucose, lipid metabolism parameters and fetal distress

目的研究妊娠期母体糖脂等代谢指标与胎儿窘迫发生的关系。方法回顾分析2014年1月至2016年1月在首都医科大学附属北京朝阳医院妇产科分娩时发生胎儿窘迫的初产妇82例，同期住院分娩无产科并发症的初产妇246例为对照组，所有孕妇均于妊娠早期检测FPG、TG、TC、HDL—C、LDL—C等生化指标。于孕24～28周行75g口服葡萄糖耐量试验（OGTT）检测空腹、1h、2h血糖水平。于分娩前检测全血血红蛋白、测量血压，比较两组孕妇糖脂、血红蛋白、血压等代谢指标及剖宫产率的差异。结果胎儿窘迫组孕妇孕早期FPG、孕中期75gOGTT中FPG、1h、2h血糖及孕晚期SBP和DBP均高于对照组，孕晚期的血红蛋白低于对照组，差异有统计学意义（P〈0．05）。胎儿窘迫组剖宫产率高于对照组，差异有统计学意义（χ2=4．489，P=0．034）。结论孕前高BMI、孕早期及孕中期血糖升高、孕晚期血压升高、孕晚期贫血均与胎儿窘迫可能有关。胎儿窘迫的孕妇剖宫产率较高。

Objective To study the relationship between gestational glucose, lipid metabolism parameters and fetal distress. Methods Retrospectively, 82 cases of primipara with fetal distress and 246 cases of primipara without any obstetric complications were analyzed. The latter were treated as control group. All the patients were from the same hospital between January, 2014 and January, 2016. Factors as fasting plasma-glucose （FPG）, triglyceride （TG）, total cholesterol （TC）,high-density lipoprotein （HDL-C）, low-density lipoprotein （LDL-C） parameters during early pregnancy, blood glucose of fasting, 1 hour and 2 hours in 75 g oral glucose tolerance test （OGTT）, at 24 to 28 weeks of gestation, hemoglobin and blood pressure parameters during ante partum were recorded for all the cases while parameters as glucose and lipid, hemoglobin, blood pressure and cesarean section rate were compared between the 2 groups. Results FPG during early gestation, blood glucose of fasting, 1 hour and 2 hours 75 g OGTT during mid gestation, systolic blood pressure and diastolic blood pressure during late gestation in the ＇fetal distress＇ group were significantly higher than that of the control group. Hemoglobin during late gestation in the fetal distress group was lower than that of the control group, with statistically significant difference （P〈0.05）. The rate of cesarean section in the fetal distress group was higher than that in the control group 0（2=4.489, P=0.034）. Conclusions High BMI at pre-pregnancy, high blood glucose during early and mid-gestation, high blood pressure and anemia during late gestation were related to the fetal distress group. Cesarean section rate was high for pregnancy women with fetal distress.