Department of Children's Health Care, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China.
World J Pediatr. 2014 May;10(2):175-81. doi: 10.1007/s12519-014-0488-7. Epub 2014 May 7.
Large-for-gestational age (LGA) newborns can increase the risk of metabolic syndrome. Previous studies have shown that the levels of maternal blood lipids, connecting peptide (C-peptide), insulin and glycosylated hemoglobin (HbA1c) were significantly different between LGA and appropriate-for-gestational age (AGA) newborns. This study aimed to determine the effect of the levels of maternal lipids, C-peptide, insulin, and HbA1c during late pregnancy on LGA newborns.
This study comprised 2790 non-diabetic women in late pregnancy. Among their newborns, 2236 (80.1%) newborns were AGA, and 554 (19.9%) newborns were LGA. Maternal and neonatal characteristics were obtained from questionnaires and their case records. The levels of maternal fasting serum apolipoprotein A1 (ApoA1), triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), C-peptide, insulin and blood HbA1c were measured. The chi-square and Mann-Whitney U test were used to analyze categorical variables and continuous variables between the AGA and LGA groups, respectively. Binary logistic regression analysis was made to determine the independent risk factors for LGA newborns.
Maternal TG, C-peptide, insulin and HbA1c levels were significantly higher in the LGA group than in the AGA group (P<0.05). The LGA group had significantly lower levels of maternal TC, HDL-C and LDL-C than the AGA group (P<0.05). After adjustment for confounding variables, including maternal age, pre-pregnancy body mass index, education, smoking, annual household income, amniotic fluid volume, gestational hypertension, newborn gender and gestational age at blood collection, high maternal TG levels remained significantly associated with LGA newborns (P<0.05).
High maternal TG level during late pregnancy is significantly associated with LGA newborns.
巨大儿（LGA）新生儿会增加代谢综合征的风险。既往研究表明，LGA 新生儿与适于胎龄（AGA）新生儿的母亲血脂、连接肽（C 肽）、胰岛素和糖化血红蛋白（HbA1c）水平存在显著差异。本研究旨在确定母亲妊娠晚期血脂、C 肽、胰岛素和 HbA1c 水平对 LGA 新生儿的影响。
本研究纳入了 2790 例非糖尿病孕妇，其中 2236 例（80.1%）新生儿为 AGA，554 例（19.9%）新生儿为 LGA。通过问卷和病历获得母亲和新生儿的特征。检测了母亲空腹血清载脂蛋白 A1（ApoA1）、甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、C 肽、胰岛素和血液 HbA1c 的水平。采用卡方检验和 Mann-Whitney U 检验分别分析 AGA 组和 LGA 组的分类变量和连续变量。采用二项逻辑回归分析确定 LGA 新生儿的独立危险因素。
LGA 组母亲的 TG、C 肽、胰岛素和 HbA1c 水平明显高于 AGA 组（P<0.05）。LGA 组母亲的 TC、HDL-C 和 LDL-C 水平明显低于 AGA 组（P<0.05）。调整混杂因素后，包括母亲年龄、孕前 BMI、教育程度、吸烟、家庭年收入、羊水体积、妊娠期高血压、新生儿性别和采血时的胎龄，高母体 TG 水平仍与 LGA 新生儿显著相关（P<0.05）。
妊娠晚期母体 TG 水平升高与 LGA 新生儿显著相关。
