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孕期孕中期母体血脂水平的流行病学分析以及根据孕期体重指数调整的不良妊娠结局风险

Epidemiological analysis of maternal lipid levels during the second trimester in pregnancy and the risk of adverse pregnancy outcome adjusted by pregnancy BMI.

作者信息

Yue Chao-Yan, Ying Chun-Mei

机构信息

Department of Laboratory Medicine, Obstetrics and Gynecology, Hospital of Fudan University, Shanghai, China.

出版信息

J Clin Lab Anal. 2018 Oct;32(8):e22568. doi: 10.1002/jcla.22568. Epub 2018 May 17.

Abstract

BACKGROUND

Pregnancy is accompanied by profound changes in lipid metabolism. We aimed to assess whether effects of second trimester body mass index and maternal lipid concentrations are associated with an increased risk of adverse pregnancy outcomes.

METHODS

We investigated the serum levels of maternal lipids during the second trimester in pregnancy, and analyzed associations between the lipid levels and the risk of adverse pregnancy outcome. Seven hundred and seventy-four pregnant women were enrolled in this study between February 2016 and June 2016. Multivariate logistic regression analysis was conducted to estimate the relative risk between maternal lipids and adverse pregnancy outcome.

RESULTS

Compared with the control group, during the second trimester of pregnancy, BMI, TG, and Lp(a) were risk factors for gestational diabetes mellitus; middle trimester pregnancy BMI, Lp(a), and APO-B were risk factors for pre-eclampsia; second trimester BMI and TG/HDL-C were risk factors for macrosomia; age and Lp(a) were uterine atony postpartum hemorrhage risk factors, while APO-AI was a protective factor of uterine inertia and postpartum hemorrhage; second trimester BMI, TCH, Lp(a), and TG/HDL-C were risk factors for fetal distress, while parity was a protective factor against fetal distress.

CONCLUSION

Abnormal blood lipid levels in pregnancy are significantly associated with GDM, pre-eclampsia, and other adverse pregnancy outcomes.

摘要

背景

孕期伴随着脂质代谢的深刻变化。我们旨在评估孕中期体重指数和母体脂质浓度的影响是否与不良妊娠结局风险增加相关。

方法

我们调查了孕期孕中期母体脂质的血清水平,并分析了脂质水平与不良妊娠结局风险之间的关联。2016年2月至2016年6月期间,774名孕妇纳入本研究。进行多因素逻辑回归分析以估计母体脂质与不良妊娠结局之间的相对风险。

结果

与对照组相比,孕期孕中期,BMI、TG和Lp(a)是妊娠期糖尿病的危险因素;孕中期BMI、Lp(a)和APO-B是子痫前期的危险因素;孕中期BMI和TG/HDL-C是巨大儿的危险因素;年龄和Lp(a)是产后宫缩乏力性出血的危险因素,而APO-AI是宫缩乏力和产后出血的保护因素;孕中期BMI、TCH、Lp(a)和TG/HDL-C是胎儿窘迫的危险因素,而产次是胎儿窘迫的保护因素。

结论

孕期血脂异常与妊娠期糖尿病、子痫前期及其他不良妊娠结局显著相关。

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