Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
(The Medical Birth Registry of Norway), Norwegian Institute of Public Health, Bergen, Norway.
BMJ Open. 2018 Jul 9;8(6):e021188. doi: 10.1136/bmjopen-2017-021188.
To study prepregnancy serum lipid levels and the association with the number of children.
Prospective, population-based cohort.
Linked data from the Cohort of Norway and the Medical Birth Registry of Norway.
2645 women giving birth to their first child during 1994-2003 (488 one-child mothers and 2157 women with ≥2 births) and 1677 nulliparous women.
ORs for no and one lifetime pregnancy (relative to ≥2 pregnancies) obtained by multinomial logistic regression, adjusted for age at examination, education, body mass index (BMI), smoking, time since last meal and oral contraceptive use.
Assessed in quintiles, higher prepregnant triglyceride (TG) and TG to high-density lipoprotein (TG:HDL-c) ratio levels were associated with increased risk of one lifetime pregnancy compared with having ≥2 children. Compared with the highest quintile, women in the lowest quintile of HDL cholesterol levels had an increased risk of one lifetime pregnancy (OR 1.7, 95% CI 1.2 to 2.4), as were women with the highest low-density lipoprotein (LDL) cholesterol, TG and TG:HDL-c ratio quintiles (compared with the lowest) (OR 1.2, 95% CI 0.8 to 1.7; OR 2.2, 95% CI 1.5 to 3.2; and OR 2.2, 95% CI 1.5 to 3.2, respectively). Similar effects were found in women with BMI≥25 and the highest LDL and total cholesterol levels in risk of lifetime nulliparity.
Women with unfavourable prepregnant lipid profile had higher risk of having no or only one child. These findings substantiate an association between prepregnant serum lipid levels and number of children. Previously observed associations between low parity and increased cardiovascular mortality may in part be due to pre-existing cardiovascular disease lipid risk factors.
研究孕前血脂水平与子女数量的关系。
前瞻性、基于人群的队列研究。
挪威队列和挪威医学出生登记处的关联数据。
1994-2003 年首次分娩的 2645 名妇女（488 名单胎母亲和 2157 名多胎妇女）和 1677 名未生育妇女。
多变量逻辑回归获得的无妊娠和单胎妊娠（相对于≥2 胎妊娠）的比值比（OR），调整了检查时的年龄、教育程度、体重指数（BMI）、吸烟、上次进餐时间和口服避孕药使用情况。
以五分位数评估，较高的孕前甘油三酯（TG）和 TG 与高密度脂蛋白（TG：HDL-c）比值水平与单胎妊娠风险增加相关，与≥2 胎妊娠相比。与最高五分位相比，HDL 胆固醇水平最低五分位的妇女单胎妊娠风险增加（OR 1.7，95%CI 1.2 至 2.4），LDL 胆固醇、TG 和 TG：HDL-c 比值最高五分位的妇女也如此（与最低五分位相比）（OR 1.2，95%CI 0.8 至 1.7；OR 2.2，95%CI 1.5 至 3.2；OR 2.2，95%CI 1.5 至 3.2）。在 BMI≥25 的妇女和 LDL 胆固醇和总胆固醇水平最高的妇女中也发现了类似的效果，其发生终生不孕的风险增加。
孕前血脂谱不良的妇女生育子女的风险较高，或只有一个子女。这些发现证实了孕前血清脂质水平与子女数量之间的关系。以前观察到的低生育率与心血管死亡率增加之间的关联，部分可能是由于存在心血管疾病的脂质危险因素。
