高龄产妇孕中期血脂水平对妊娠并发症的影响

Effect of Blood Lipid Level in the Second Trimester of Advanced Maternal Age on Pregnancy Complications

目的探讨孕妇年龄和孕中期血脂水平对妊娠并发症的影响。方法回顾性收集2018年7月至2019年12月于西南医科大学附属医院建卡产检孕妇的临床资料,按年龄分成两组,<35岁为适龄产妇组,共857例;≥35岁为高龄产妇组,共380例。分析比较孕妇年龄和孕中期血脂水平对妊娠并发症的影响。结果在适龄产妇组中,甘油三酯(TG)与巨大儿、早产呈正相关,胆固醇(TC)与早产呈正相关;TG预测巨大儿、早产的最佳截断点分别为≥3.425、2.635 mmol/L;TC预测早产的最佳截断点≥6.160 mmol/L。在高龄产妇组中,TG与巨大儿、妊娠期糖尿病、子痫前期、早产呈正相关;TC与子痫前期、早产呈正相关;TG预测巨大儿、妊娠期糖尿病、子痫前期、早产的最佳截断点分别为≥3.580、3.555、3.395、3.395 mmol/L;TC预测子痫前期、早产的最佳截止点分别为≥7.230、5.935 mmol/L。结论孕中期血脂水平可以预测妊娠并发症,且与年龄有关。临床上应根据不同年龄组,有针对性地采取围生期检查及保健工作,预防妊娠并发症发生。

Objective To investigate the effect of maternal age and blood lipid levels in the second trimester on pregnancy complications.Methods The clinical data of pregnant women who underwent obstetric examinations in the Affiliated Hospital of Southwest Medical University from July 2018 to December 2019 were retrospectively collected.The patients were divided into 2 groups according to age normal maternal age group(n=857,age<35 years old),and advanced maternal age group(n=380,age≥35 years old).The effects of maternal age and blood lipid levels in the second trimester on pregnancy complications were analyzed and compared.Results In the normal maternal age group,triglyceride(TG)was positively correlated with macrosomia and preterm birth,and total cholesterol(TC)was positively correlated with preterm birth.The optimal cutoff points of TG for predicting macrosomia and preterm birth were≥3.425 mmol/L and 2.635 mmol/L,respectively.The optimal cutoff point of TC for predicting preterm birth was≥6.160 mmol/L.In the advanced maternal age group,TG was positively correlated with macrosomia,gestational diabetes mellitus,preeclampsia and preterm birth,and TC was positively correlated with preeclampsia and preterm birth.The optimal cutoff points of TG for predicting macrosomia,gestational diabetes mellitus,preeclampsia and preterm birth were≥3.580 mmol/L,≥3.555 mmol/L,≥3.395 mmol/L and≥3.395 mmol/L,respectively.The optimal cutoff points of TC for predicting preeclampsia and preterm birth were≥7.230 mmol/L and 5.935 mmol/L,respectively.Conclusion Blood lipid levels in the second trimester can predict pregnancy complications and are correlated with age.Clinically,targeted perinatal examination and health care should be employed according to different age groups to prevent pregnancy complications.