正常孕妇妊娠中晚期血脂水平与巨大儿发生风险的关系分析

Analysis of relationshipbetween maternal serum lipid levels and macrosomia risk in normal pregnant women in the second and third trimesters of pregnancy

目的探讨正常孕妇妊娠中晚期血脂水平与巨大儿发生风险的关系。方法选取2020年9~12月在中国福利会国际和平妇幼保健院定期产检的无高危风险健康孕妇作为研究对象进行回顾性研究,根据新生儿出生体重分为巨大儿组(94例)和对照组(259例)。比较妊娠中晚期两组一般资料及血清总胆固醇(total cholesterol,TC),甘油三酯(triglycerides,TG),低密度脂蛋白(low density lipoprotein,LDL)和高密度脂蛋白(high density lipoprotein,HDL)水平,分析各血脂指标对巨大儿发生的影响。结果巨大儿组孕妇身高、孕前体重、体质量指数(body mass index,BMI)、孕期增重、分娩前体重、丈夫体重[(1.64±0.49)m、(58.00±5.47)kg、(21.43±1.87)kg/m^(2)、(17.15±4.10)kg、(75.15±6.41)kg、(75.15±10.15)kg]均高于对照组[(1.63±0.56)m、(54.86±5.66)kg、(20.60±1.59)kg/m^(2)、(14.14±4.70)kg、(68.98±7.16)kg、(72.44±9.97)kg];妊娠中、晚期巨大儿组TG、TG/HDL[(1.38±0.62)mmol/L、0.83、(3.00±0.91)mmol/L、1.64]均显著高于对照组[(1.24±0.51)mmol/L、0.65、(2.67±0.93)mmol/L、1.27],差异有统计学意义(P<0.05)。孕妇分娩前体重、丈夫体重、孕晚期高TG/HDL值是巨大儿发生的独立危险因素。结论孕期血脂升高与巨大儿发生有关,孕期需监测血脂变化水平。正常孕妇孕晚期TG/HDL升高有助于发现隐匿性巨大儿,从而减少不良妊娠结局。

Objective To investigate the relationship between blood lipid levels in the second and third trimesters of pregnancy and the risk of macrosomia in normal pregnant women.Methods A retrospective study was conducted on healthy pregnant women without high risk who received regular obstetric examinations at International Peace Maternal and Child Health Hospital of China Welfare Association from September to December 2020.According to the birth weight of newborns, they were divided into macrosomia group(94 cases) and control group(259 cases).The general data and serum levels of TG,TC,HDL,and LDL were compared between the two groups in the second and third trimesters of pregnancy, and the effects of each blood lipid index on macrosomia were analyzed.Results The height, pre-pregnancy weight, body mass index(BMI),weight gain during pregnancy, pre-delivery weight, and husband’s weight in macrosomia group [(1.64±0.49)m,(58.00±5.47)kg,(21.43±1.87)kg/m^(2),(17.15±4.10)kg,(75.15±6.41)kg,(75.15±10.15)kg] were higher than those in control group[(1.63±0.56)m,(54.86±5.66)kg,(20.60±1.59)kg/m^(2),(14.14±4.70)kg,(68.98±7.16)kg,(72.44±9.97)kg];TG and TG/HDL were significantly higher in macrosomia group in the second and third trimesters of pregnancy[(1.38±0.62) mmol/L,0.83,(3.00±0.91)mmol/L,1.64] compared with the control group[(1.24±0.51)mmol/L,0.65,(2.67±0.93)mmol/L,1.27],the differences were statistically significant(P<0.05).Prenatal weight, husband’s weight, and high TG/HDL levels in the third trimester were independent risk factors for macrosomia.Conclusion Elevated blood lipids during pregnancy are related to macrosomia, and changes in blood lipids should be monitored during pregnancy.Elevated TG/HDL in the third trimester of normal pregnant women can help to detect occult macrosomia, thereby reducing adverse pregnancy outcomes.