Department of Endocrinology, Shandong Provincial Hospital affiliated to Shandong University, Jinan, Shandong, 250021, China.
Shandong Clinical Medical Center of Endocrinology and Metabolism, Jinan, Shandong, 250021, China.
Lipids Health Dis. 2018 Apr 11;17(1):78. doi: 10.1186/s12944-018-0707-7.
Macrosomia is a serious public health problem worldwide due to its increasing prevalence and adverse influences on maternal and neonatal outcomes. Maternal dyslipidemia exerts potential and adverse impacts on pregnant women and newborns. However, the association between maternal serum lipids and the risk of macrosomia has not yet been clearly elucidated. We explored the association between the maternal lipids profile at late gestation and the risk of having macrosomia among women without diabetes mellitus (DM).
The medical records of 5407 pregnant women giving birth to single live babies at term were retrospectively analyzed. Subjects with DM, hypertension, thyroid disorders and fetal malformation were excluded. Maternal fasting serum lipids were measured during late pregnancy. Logistic regression analysis was used to analyze the variables associated with the risk of macrosomia.
Maternal serum triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C) levels were related to macrosomia; each 1 mmol/L increase in TG resulted in a 27% increase in macrosomia risk, while each 1 mmol/L increase in HDL-C level resulted in a 37% decrease in macrosomia risk, even after adjusting for potential confounders. Notably, the risk of macrosomia increased progressively with increased maternal serum TG levels and decreased HDL-C levels. Compared with women with serum TG levels < 2.5 mmol/L, women with TG levels greater than 3.92 mmol/L had an approximately 2.8-fold increased risk of macrosomia. Compared with women with serum HDL-C levels above 2.23 mmol/L, women with HDL-C levels of less than 1.62 mmol/L had a 1.9-fold increased risk of giving birth to an infan with macrosomia. In addition, a higher risk of macrosomia was observed in women with simultaneous hypertriglyceridemia and low serum HDL-C levels (odds ratio [OR] 2.400, 95% confidence interval [CI]: 1.760-3.274) compared to those with hypertriglyceridemia or low serum HDL-C alone (OR 2.074, 95% CI: 1.609-2.673 and OR 1.363, 95% CI: 1.028-1.809, respectively).
Maternal serum TG levels and HDL-C levels at late gestation are independent predictors of macrosomia in women without DM.
巨大儿是一个严重的全球公共卫生问题，其患病率不断增加，对母婴结局有不良影响。母体血脂异常对孕妇和新生儿有潜在的不良影响。然而，母体血清脂质与巨大儿风险之间的关系尚未阐明。我们探讨了孕晚期母体血脂谱与无糖尿病（DM）女性巨大儿风险之间的关系。
回顾性分析了 5407 例单胎足月分娩的孕妇的病历。排除 DM、高血压、甲状腺疾病和胎儿畸形患者。在孕晚期测量孕妇空腹血清脂质。采用 logistic 回归分析与巨大儿风险相关的变量。
母体血清三酰甘油（TG）和高密度脂蛋白胆固醇（HDL-C）水平与巨大儿有关；TG 每增加 1mmol/L，巨大儿风险增加 27%，而 HDL-C 每增加 1mmol/L，巨大儿风险降低 37%，即使在调整了潜在混杂因素后也是如此。值得注意的是，随着母体血清 TG 水平的升高和 HDL-C 水平的降低，巨大儿的风险逐渐增加。与 TG 水平<2.5mmol/L 的女性相比，TG 水平>3.92mmol/L 的女性巨大儿风险增加约 2.8 倍。与 HDL-C 水平>2.23mmol/L 的女性相比，HDL-C 水平<1.62mmol/L 的女性巨大儿风险增加 1.9 倍。此外，与单独高甘油三酯血症或低血清 HDL-C 相比，同时存在高甘油三酯血症和低血清 HDL-C 的女性巨大儿风险更高（比值比 [OR] 2.400，95%置信区间 [CI]：1.760-3.274）（OR 2.074，95%CI：1.609-2.673 和 OR 1.363，95%CI：1.028-1.809）。
孕晚期母体血清 TG 水平和 HDL-C 水平是无 DM 女性巨大儿的独立预测因子。
