孕妇血脂水平与巨大儿的关系

Relations between maternal blood lipids and macrosomia

目的探讨孕妇孕期血脂与新生儿体重及巨大儿出生的关系。方法受检对象为2017年1月1日至12月31日在解放军第306医院妇产科自然受孕、足月单胎分娩巨大儿的健康孕妇(96例,巨大儿组)和分娩正常体重新生儿的健康孕妇(140例,对照组),测量孕妇孕前身高、体重,计算体质量指数,在孕36~37周检测空腹血脂,测量新生儿出生时的身长与体重,并对数据进行分析。结果巨大儿组孕妇的身高、孕前体重、孕前体质量指数、分娩前体重、分娩时孕龄、甘油三脂、血浆动脉硬化指数(AIP)、新生儿体重、新生儿身长及剖宫产率均显著高于对照组(t/χ~2=-4.924~6.562,均P<0.01);而且身高、孕前体重、孕前体质量指数、分娩前体重、分娩时孕龄、甘油三脂及血浆AIP均与新生儿体重呈显著正相关(r值分别为0.183、0.254、0.199、0.280、0.508、0.213、0.238,均P<0.01);采用多元线性回归分析结果显示:新生儿体重与AIP呈正相关(β=0.423,P<0.05)。结论孕期血脂水平普遍升高,孕期甘油三脂水平过度升高可能与巨大儿发生的危险性有关,此外AIP有可能对观测血脂与巨大儿的相关性有一定的价值。

Objective To explore the relations between maternal lipids and newborn weight and macrosomia.Methods All subjects in this study were naturally conceived and healthy pregnant women with singleton pregnancy who delivered full term macrosomia（96 cases,macrosomia group）and those who delivered normal weight full term newborns（140 cases,control group）during the period of January 1 st 2017 to December 31 st 2017 in the 306 th Hospital of PLA.Pre-pregnancy height and weight of women were measured and their body mass index（BMI）was calculated.Fasting serum lipids were analyzed at 36-37 weeks of gestation.Weights and heights of newborns were measured at birth,and data were processed.Results Height,pre-pregnancy weight and BMI,weight before delivery,weeks of gestation at labor,levels of triglyceride and atherogenic index of plasma（AIP）,neonatal weight and height and rates of cesarean section in macrosomia group were significantly higher than those in control group（t/χ~2 value ranged-4.924-6.562,all P〈0.01）.And height,pre-pregnancy weight,and BMI,weight before delivery,weeks of gestation at labor,and levels of triglyceride and AIP were positively correlated with weights of newborns（r value was 0.183,0.254,0.199,0.280,0.508,0.213 and 0.238,respectively,all P〈0.01）.Results of multiple linear regression analysis showed that newborn weight was positively correlated with AIP（β=0.423,P〈0.05）.Conclusion The blood lipid levels are elevated in pregnant women generally.The excessive increased level of triglyceride in pregnancy may be associated with risk of macrosomia.In addition,AIP may has certain value in observing the correlations between blood lipid and macrosomia.