孕早期糖脂水平与新生儿出生体重相关性的研究

Association of early pregnancy fasting plasma glucose and lipid concentrations and neonatal birth weight

目的探讨孕早期血糖血脂水平与新生儿出生体重的关系。方法回顾性分析2011年8月至2012年2月在北京妇产医院进行常规产前检查的孕妇临床资料,记录首次产检空腹血清葡萄糖(FPG)和血脂[包括甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)和总胆固醇(TC)]的检测孕周及实验室结果,并按所有研究对象的第75百分位数分组,并对资料进行统计分析。结果孕早期的FPG(r=0.064,P<0.01)、TC(r=0.055,P=0.01)、TG(r=0.063,P<0.01)和LDL-C(r=0.078,P<0.01)水平均分别与新生儿出生体重显著正相关。TG≥1.49mmol/L组的新生儿出生体重(3 472.4±427.7g)明显高于TG<1.49mmol/L组(3 427.4±388.9g),并且巨大儿所占比例也高于TG<1.49mmol/L组(11.2%vs7.2%),差异均有统计学意义(t=2.11,P<0.05;χ~2=8.43,P<0.05)。结论孕早期的TG水平与新生儿的出生体重和巨大儿发生相关。因此,临床上应关注孕早期的糖脂代谢,特别是确定不同孕期的血脂指标适宜范围,以便及早对代谢异常的孕妇进行生活方式指导和相关干预,从而改善妊娠结局。

Objective To evaluate the association of fasting plasma glucose（ FPG） and blood lipid concentrations in early pregnancy with neonatal birth weight. Methods Retrospective study was conducted on the clinical data of pregnant women taking regular prenatal examinations in Beijing Obstetrics and Gynecology Hospital during the period of August 2011 to February 2012. The gestational week when testing FPG and lipid（ TG,HDL-C,LDL-C,TC） at the first prenatal visit as well as laboratory results were recorded,and the subjects were grouped basing on 75 th percentile. The analysis of variance,Student＇s t test,Chi-square test and Spearman correlation analysis were used for statistical analysis. Results Maternal FPG（ r = 0. 064,P〈 0. 01）,TC（ r = 0. 055,P = 0. 01）,TG（ r = 0. 063,P〈 0. 01） and LDL-C（ r = 0. 078,P〈 0. 01） were positively correlated with neonatal birth weight. Neonates from mothers with TG ≥1. 49 mmol/L（ 3 472. 4 ± 427. 7g） had higher birth weight and prevalence of macrosomia（ 11. 2%） than those with TG〈 1. 49mmol/L（ 3 427. 4 ±388. 9g,7. 2%）. The differences were statistically significant（ t = 2. 11,P〈 0. 05; χ~2= 8. 43,P〈 0. 05）. Conclusion TG level in early pregnancy is associated with neonatal birth weight and occurrence of macrosomia. Therefore,glucose and lipid metabolism in early pregnancy should be focused in clinics,especially defining the optimal maternal blood lipid ranges during pregnancy so as to provide guidance and intervention for life styles of pregnant women and thus improve pregnancy outcomes.