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母亲孕期血脂水平与小于胎龄儿风险的关系。

Association between maternal blood lipids levels during pregnancy and risk of small-for-gestational-age infants.

机构信息

Department of Obstetrics, Women's Hospital, Zhejiang University School of Medicine, No.1 Xueshi Road, Hangzhou, China.

Department of Public Health, Zhejiang University School of Medicine, 866 Yuhangtang Road, Hangzhou, China.

出版信息

Sci Rep. 2020 Nov 16;10(1):19865. doi: 10.1038/s41598-020-76845-1.

Abstract

Dyslipidemia in pregnancy are associated with risk of adverse outcomes. As an adverse pregnancy outcome, small-for-gestational-age has been extensively studied in Western countries. However, similar studies have rarely been conducted in Asian countries. Data were derived from 5695 pairs of non-diabetic mothers and neonates between 1 Jan 2014 and 31 Dec 2014. 5.6% neonates in our study were SGA. Serum samples were collected during second and third trimesters for evaluation on fasting lipids levels. The present study intended to explore the associations between maternal lipid profile and small-for-gestational-age neonates. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated and adjusted via logistic regression analysis. After adjustments for confounders, third-trimester total cholesterol levels were associated with a decreased risk for small-for-gestational-age (aOR = 0.622, 95% CI 0.458-0.848, P = 0.002), and third-trimester high-density lipoprotein cholesterol and low-density lipoprotein cholesterol levels were associated with an increased risk for small-for-gestational-age (aOR = 1.955, 95% CI 1.465-2.578, P < 0.001; aOR = 1.403, 95% CI 1.014-1.944, P = 0.041).In the highest gestational weight gain strata, especially the third-trimester, the effect of high-density lipoprotein cholesterol levels on the risk for small-for-gestational-age is larger. High high-density lipoprotein cholesterol level during third trimester could be considered as indicators of a high-risk of small-for-gestational-age, regardless of gestational weight gain.

摘要

妊娠期间血脂异常与不良结局风险相关。作为一种不良妊娠结局,胎儿小于胎龄在西方国家已得到广泛研究。然而,亚洲国家类似的研究很少。本研究的数据来自于 2014 年 1 月 1 日至 12 月 31 日期间的 5695 对非糖尿病母亲及其新生儿。我们的研究中,有 5.6%的新生儿是小于胎龄儿。在妊娠第二和第三阶段收集血清样本,评估空腹血脂水平。本研究旨在探讨母体血脂特征与胎儿小于胎龄之间的关系。通过逻辑回归分析计算并调整比值比(OR)和 95%置信区间(CI)。调整混杂因素后,第三阶段总胆固醇水平与胎儿小于胎龄的风险降低相关(aOR=0.622,95%CI 0.458-0.848,P=0.002),第三阶段高密度脂蛋白胆固醇和低密度脂蛋白胆固醇水平与胎儿小于胎龄的风险增加相关(aOR=1.955,95%CI 1.465-2.578,P<0.001;aOR=1.403,95%CI 1.014-1.944,P=0.041)。在最高的妊娠体重增加分层中,特别是在第三阶段,高密度脂蛋白胆固醇水平对胎儿小于胎龄的风险的影响更大。第三阶段高密度脂蛋白胆固醇水平升高可被视为胎儿小于胎龄的高危指标,而与妊娠体重增加无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd3e/7669834/7b3f35b46ca6/41598_2020_76845_Fig1_HTML.jpg

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