孕前体重指数与妊娠期糖脂代谢指标的相关性研究及妊娠结局影响因素分析

Correlation between pre-pregnancy body mass index and glucose and lipid metabolism indexes and their influences on pregnancy outcome

目的探讨孕前体重指数(BMI)与妊娠期糖脂代谢指标的相关性及妊娠结局影响因素分析。方法选取2021年在石家庄市妇幼保健院做产前检查的孕妇103例,按照孕前BMI分为低BMI组13例、正常BMI组53例、高BMI组37例,比较3组空腹、1 h、2 h葡萄糖耐量试验(OGTT)血脂代谢指标[胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)]、妊娠不良结局发生情况,以妊娠结局为因变量,以年龄、BMI、文化程度、家庭人均月收入、既往流产史、既往妊娠史、吸烟史、饮酒、阴道大量出血、宫内大血肿为自变量,分析妊娠不良结局的影响因素。结果低BMI组、正常BMI组、高BMI组空腹OGTT、1 h OGTT、2 h OGTT、TG、TC、LDL-C水平依次升高,HDL-C水平依次降低,差异均有统计学意义(P<0.05)。高BMI组妊娠不良结局发生率显著高于正常BMI组、低BMI组(P<0.05)。103例患者共有34例发生妊娠不良结局,经多因素二元Logistic分析,BMI正常是妊娠不良结局的保护因素(P<0.05),阴道大量出血、宫内大血肿是妊娠不良结局的危险因素(P<0.05)。结论孕前BMI高会导致高血糖,高TG、TC、LDL-C,低HDL-C,导致妊娠不良结局。保持BMI正常可减少妊娠不良结局,对阴道大量出血、宫内大血肿孕妇需做好妊娠不良结局预防干预措施。

Objective To explore the correlation between pre-pregnancy body mass index(BMI)and glucose and lipid metabolism indexes and their influences on pregnancy outcome.Methods A total of 103 pregnant women who underwent prenatal examination in Shijiazhuang Maternal and Child Health Hospital from January 2021 to December 2021 were recruited and divided into low BMI group(n=13),normal BMI group(n=53),and high BMI group(n=37),the blood lipid metabolism and the occurrence of adverse pregnancy outcomes(APOs)among the three groups were compared.The influencing factors of adverse pregnancy outcomes were analyzed by pregnancy outcomes as the dependent variable,and age,BMI,education level,monthly household income per capita,previous induced abortion,previous pregnancy history,smoking history,drinking history,heavy vaginal bleeding,and intrauterine hematoma as the independent variables.Results Comparison of fasting oral glucose tolerance test(OGTT),1-h OGTT,2-h OGTT,triglyceride(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C)among three groups:low BMI group<normal BMI group<high BMI group.Comparison of high-density lipoprotein cholesterol(HDL-C)among three groups:low BMI group>normal BMI group>high BMI group,with statistical significance differences(P<0.05).The incidence of adverse pregnancy outcomes in the high BMI group(59.46%vs 15.38%,59.46%vs 18.87%)was significantly higher than that in the normal BMI group and the low BMI group(P<0.05).A total of 34 cases of 103 patients had adverse pregnancy outcomes.After multivariate binary Logistic analysis,normal BMI was a protective factor for adverse pregnancy outcomes(P<0.05),the heavy vaginal bleeding and intrauterine hematoma were risk factors for adverse pregnancy outcomes(P<0.05).Conclusion High pre-pregnancy BMI associated with high blood sugar,high TG,TC,LDL-C,and low HDL-C,leading to poor pregnancy outcomes.Maintaining a normal BMI can reduce adverse pregnancy outcomes.Pregnant women with heavy vaginal bleeding and intrauterine hematoma need to take preventive interventions for adverse pregnancy outcomes.