Department of Obstetrics, Gynecology and Reproductive Sciences, Magee Womens Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Obesity (Silver Spring). 2014 Mar;22(3):932-8. doi: 10.1002/oby.20576. Epub 2013 Dec 2.
The impact of maternal overweight/obesity and excessive weight gain on maternal serum lipids in the first and second trimester of pregnancy was evaluated.
Prospective data were collected for 225 women. Maternal serum lipids and fatty acids were measured at <13 weeks and between 24 and 28 weeks. Analyses were stratified by normal weight versus overweight/obese status and excessive versus nonexcessive weight gain.
Overweight/obese women had higher baseline cholesterol (161.3 ± 29.6 vs. 149.4 ± 26.8 mg/dl, P < 0.01), low-density lipoprotein LDL (80.0 ± 19.9 vs. 72.9 ± 18.8 mg/dl, P < 0.01), and triglycerides (81.7 ± 47.2 vs. 69.7 ± 40.3 mg/dl, P = 0.05) when compared to normal weight women, whereas high-density lipoprotein (43.6 ± 10.4 vs. 47.6 ± 11.5 mg/dl, P < 0.01) was lower. However, cholesterol and LDL increased at a higher weekly rate in normal weight women, resulting in higher total cholesterol in normal weight women (184.1 ± 28.1 vs. 176.0 ± 32.1 mg/dl, P = 0.05) at 24-28 weeks. The rate of change in lipid profiles in either group was not affected by excessive weight gain. Overweight/obese women had higher levels of arachidonic acid at both time points.
Overweight/obese women have significantly more atherogenic lipid profiles than normal weight women during the period of early pregnancy, delineating one physiologic pathway between that could explain differences in pregnancy outcomes normal weight and overweight/obese women.
评估孕妇超重/肥胖及体重过度增加对妊娠 1 至 2 期母体血清脂质的影响。
前瞻性收集了 225 名女性的数据。在<13 周和 24 至 28 周时测量母体血清脂质和脂肪酸。根据正常体重与超重/肥胖状况以及体重过度增加与非过度增加进行分层分析。
与正常体重女性相比，超重/肥胖女性的基线胆固醇（161.3±29.6 与 149.4±26.8 mg/dl，P<0.01）、低密度脂蛋白（LDL）（80.0±19.9 与 72.9±18.8 mg/dl，P<0.01）和甘油三酯（81.7±47.2 与 69.7±40.3 mg/dl，P=0.05）更高，而高密度脂蛋白（HDL）（43.6±10.4 与 47.6±11.5 mg/dl，P<0.01）更低。然而，正常体重女性的胆固醇和 LDL 以更高的周增长率增加，导致正常体重女性在 24-28 周时总胆固醇更高（184.1±28.1 与 176.0±32.1 mg/dl，P=0.05）。两组的脂质谱变化率均不受体重过度增加的影响。超重/肥胖女性在两个时间点的花生四烯酸水平均较高。
在妊娠早期，超重/肥胖女性的致动脉粥样硬化脂质谱明显高于正常体重女性，这阐明了超重/肥胖和正常体重女性在妊娠结局方面存在差异的一种生理途径。
