Mossayebi Elaheh, Arab Zohreh, Rahmaniyan Mojgan, Almassinokiani Fariba, Kabir Ali
Assistant Professor of Obstetrics and Gynecology, Shahid Akbar Abadi Hospital, Iran University of Medical Sciences, Tehran, Iran.
Assistant of Obstetrics and Gynecology, Shahid Akbar Abadi Hospital, Iran University of Medical Sciences, Iran.
Pediatr Neonatol. 2014 Feb;55(1):28-34. doi: 10.1016/j.pedneo.2013.05.006. Epub 2013 Aug 2.
The aim of this study is to identify the association between the lipid profile of healthy nondiabetic, nonobese pregnant women in the first weeks of the third trimester of pregnancy and macrosomia or large-for-gestational-age (LGA) neonates with normal pregnancies.
In this cohort study, 200 pregnant healthy women without gestational diabetes mellitus (GDM), obesity, or hypertension and carrying a single fetus in a prenatal clinic of a referral hospital were included based on a convenience sampling. Then, we took a blood sample to assess fasting blood sugar (FBS), triglyceride (TG), total cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL). GDM was assessed after administering 50 g of oral glucose. All cases were followed until the end of pregnancy. The main outcome measurement was neonatal birth weight.
Only 154 mothers met eligibility criteria. There were eight cases (5.2%) with macrosomia (birth weight ≥ 4000 g) and 35 cases (22.7%) with LGA. Linear regression showed that mothers' TG and neonates' gender were independent predictors of the birth weight of the children (R-square = 0.52, p < 0.001). Logistic regression analysis showed that maternal FBS and TG are the most independent variables which can predict the presence of macrosomia (Nagelkerke R-square = 0.53, p < 0.001) and maternal TG and child gender are the most independent variables that can predict the presence of LGA in neonates of a healthy mother (Nagelkerke R-square = 0.49, p < 0.001).
Maternal triglyceride levels may be a significant predictor of fetal size in late pregnancy but not in early pregnancy. Our study reinforces that this is true not only in the case of macrosomia (birth weight > 4500 g), but also for LGA.
本研究的目的是确定妊娠晚期头几周健康的非糖尿病、非肥胖孕妇的血脂水平与巨大儿或正常妊娠的大于胎龄(LGA)新生儿之间的关联。
在这项队列研究中,基于便利抽样,纳入了一家转诊医院产前诊所的200名无妊娠糖尿病(GDM)、肥胖或高血压且单胎妊娠的健康孕妇。然后,我们采集血样以评估空腹血糖(FBS)、甘油三酯(TG)、总胆固醇、低密度脂蛋白(LDL)和高密度脂蛋白(HDL)。口服50克葡萄糖后评估GDM。所有病例随访至妊娠结束。主要结局指标是新生儿出生体重。
只有154名母亲符合纳入标准。有8例(5.2%)巨大儿(出生体重≥4000克)和35例(22.7%)LGA。线性回归显示,母亲的TG和新生儿性别是儿童出生体重的独立预测因素(决定系数R² = 0.52,p < 0.001)。逻辑回归分析显示母亲的FBS和TG是预测巨大儿存在的最独立变量(Nagelkerke决定系数R² = 0.53,p < 0.001),母亲的TG和儿童性别是预测健康母亲新生儿LGA存在的最独立变量(Nagelkerke决定系数R² = 0.49,p < 0.001)。
母亲甘油三酯水平可能是妊娠晚期胎儿大小的重要预测指标,但不是妊娠早期。我们的研究强化了这不仅适用于巨大儿(出生体重>4500克)的情况,也适用于LGA。