母亲血脂水平对新生儿肥胖的影响

Effect of maternal blood lipid level on neonatal obesity

目的 探讨母亲血脂水平和新生儿肥胖的关系。方法 收集在商丘市妇幼保健院进行产前检查的妇女作为研究对象。其中妊娠期糖尿病(GDM)162例,选取同时期在进行产前检查的糖耐量正常(NGT)486例。486例NGT中,肥胖137例,非肥胖349例。对比分析3组妇女的一般资料及新生儿结局。结果 母亲妊娠期间体重增加(GWG)>10 kg(OR=3.548,P=0.000)、男性胎儿(OR=2.193,P=0.016)、母亲基线空腹甘油三酯(TG)>90百分位数(OR=3.025,P=0.000)是新生儿出生体重(BW)>90百分位数的危险因素。母亲基线TG>90百分位数(OR值4.129,P值0.000)、GWG>10kg(OR值2.829,P=0.002)是大于胎龄儿(LGA)的危险因素。分娩孕周>39周(OR=2.024,P=0.006)、母亲基线TG>90百分位数(OR=3.819,P=0.000)是新生儿BWR>90百分位数的危险因素。年龄≥30岁(OR=1.418,P=0.017)、GWG>10 kg(OR=3.894,P=0.000)、产次≥2次(OR=2.436,P=0.000)是新生儿皮褶厚度总和(SSFT)>90百分位数的危险因素。结论 新生儿肥胖主要和母亲血脂异常、GWG高存在关联,与母亲血糖水平、胰岛素抵抗和孕前体重指数无关。

Objective To explore the relationship between maternal blood lipid level and neonatal obesity.Methods Women who had undergone antenatal examination in our hospital were recruited as research objects.Among them,there were 162 cases with gestational diabetes mellitus(GDM),and 486 cases with normal glucose tolerance(NGT)were recruited.Among 486 NGT cases,there were 137 obese cases and 349 non-obese cases.The general da⁃ta and neonatal outcomes of three groups of women were compared and analyzed.Results The gestational weight gain(GWG)>10 kg(OR=3.548,P=0.000),male fetus(OR=2.193,P=0.016),and maternal baseline fasting tri⁃glyceride(TG)>90 percentile(OR=3.025,P=0.000)were the risks of neonatal birth weight>90 percentile.TG>90 percentile(OR=4.129,P=0.000)and GWG>10 kg(OR=2.829,P=0.002)were the risk factors of large for gestational age(LGA).The gestational age of delivery>39 weeks(OR=2.024,P=0.006)and the mother's baseline TG>90 percentile(OR=3.819,P=0.000)were the risk factors of birth weight ratio(BWR)>90 percen⁃tile.Age≥30 years(OR=1.418,P=0.017),GWG>10 kg(OR=3.894,P=0.000),and parity≥2 times(OR=2.436,P=0.000)were the risk factors of sum of skin fold thickness(SSFT)>90 percentile.Conclusion Newborn obesity is mainly associated with maternal dyslipidemia and high GWG,but not with maternal blood glucose level,insulin resistance and pre-pregnancy body mass index.