高三酰甘油血症对BGGI孕妇妊娠结局和并发症的影响

The Effect of Hypertriglyceridemia on Pregnancy Outcome and Complications of BGGI Pregnant Women

目的评价高三酰甘油(TG)血症对交界性糖耐量受损(BGGI)孕妇妊娠结局和并发症,以及对孕妇产后恢复和新生儿生长的影响。方法216例合并高TG血症的BGGI孕妇作为高TG组,184例TG正常的孕妇作为对照组。比较两组孕妇妊娠结局和新生儿结局,比较产后6周时的FPG、2hPG、HbA1c、TC、低LDL和HDL水平,比较产后6周时的孕妇体重增加、糖尿病发生率和新生儿体重。结果与对照组比较,高TG组的孕妇体重增加和新生儿体重明显偏高,APGAR评分明显偏低,产后出血、剖宫产、GDM和巨大儿发生率上升,差异均具有统计学意义(P<0.05)。产后6周时高TG组的FPG、2hPG、HbA1c、TC和LDL明显高于对照组,差异具有统计学意义(P<0.05)。产后6周时高TG组糖脂代谢异常率、糖尿病发生率、孕妇及新生儿体重均显著高于对照组,差异具有统计学意义(P<0.05)。Pearson相关分析显示产后6周时孕妇体重增加、糖尿病和新生儿体重与FPG、2hPG、HbA1c、TC和LDL呈正相关关系(P<0.05)。结论合并高TG血症的BGGI孕妇不良母婴结局的发生率相对偏高,并且产后糖、脂恢复较慢;糖、脂水平与产后孕妇恢复和新生儿生长发育具有一定的相关性。

Objective To evaluate the effect of hypertriglyceridemia(TG)on pregnancy outcome and complications of borderline impaired glucose tolerance(BGGI)pregnant women and its clinical value in postpartum recovery and neonatal growth. Methods A total of 216 pregnant women with BGGI and high levels of TG were selected as the high TG group,while 184 pregnant women with normal TG level were selected as the control group.The pregnancy outcomes and neonatal outcomes were compared between the two groups.FPG,2hPG,HbA1c,TC,low LDL,and HDL were compared at 6 weeks after the delivery.The weight gain,diabetes incidence,and neonatal weight of pregnant women at 6 weeks after the delivery were also compared. Results Compared with the control group,the weight gain of the pregnant women and neonatal weight in the high TG group were significantly higher,while the PGAR score was significantly lower.The incidence of postpartum hemorrhage,cesarean section,GDM and macrosomia increased,and the difference was statistically significant( P <0.05).The levels of FPG,2hPG,HbA1c,TC and LDL in the high TG group were significantly higher than those in the control group at 6 weeks after the delivery( P <0.05).At 6 weeks after the delivery,the abnormal rate of glucose and lipid metabolism,the incidence of diabetes,the weight of pregnant women and neonates in the high TG group were significantly higher than those in the control group( P <0.05).Pearson correlation analysis showed that the weight gain of pregnant women,diabetes and neonatal weight were all positively correlated with the levels of FPG,2hPG,HbA1c,TC and LDL at 6 weeks after the delivery( P <0.05). Conclusion The incidence of adverse maternal and child outcomes in pregnant women with BGGI and high TG is relatively high,and the recovery of postpartum glucose and lipid is slow.The glucose and lipid levels are correlated with postpartum maternal recovery and neonatal development.