Department of Obstetrics & Gynecology, Jewish General Hospital, McGill University, Montreal, QC, Canada.
Centre for Clinical Epidemiology, Jewish General Hospital, Montreal, QC, Canada.
J Perinat Med. 2021 Jul 1;49(9):1129-1134. doi: 10.1515/jpm-2021-0028. Print 2021 Nov 25.
The effects of lipid metabolism disorders (LMD) on pregnancy outcomes is not well known. The purpose of this study is to evaluate the impact of LMD on maternal and fetal outcomes.
Using the Healthcare Cost and Utilization Project - National Inpatient Sample from the United States, we carried out a retrospective cohort study of all births between 1999 and 2015 to determine the risks of complications in pregnant women known to have LMDs. All pregnant patients diagnosed with LMDs between 1999 and 2015 were identified using the International Classification of Disease-9 coding, which included all patients with pure hypercholesterolemia, pure hyperglyceridemia, mixed hyperlipidemia, hyperchylomicronemia, and other lipid metabolism disorders. Adjusted effects of LMDs on maternal and newborn outcomes were estimated using unconditional logistic regression analysis.
A total of 13,792,544 births were included, 9,666 of which had an underlying diagnosis of LMDs for an overall prevalence of 7.0 per 10,000 births. Women with LMDs were more likely to have pregnancies complicated by diabetes, hypertension, and premature births, and to experience myocardial infarctions, venous thromboembolisms, postpartum hemorrhage, and maternal death. Their infants were at increased risk of congenital anomalies, fetal growth restriction, and fetal demise.
Women with LMDs are at significantly higher risk of adverse maternal and newborn outcomes. Prenatal counselling should take into consideration these risks and antenatal care in specialized centres should be considered.
脂质代谢紊乱（LMD）对妊娠结局的影响尚不清楚。本研究旨在评估 LMD 对母婴结局的影响。
本研究使用美国医疗保健成本与利用项目-国家住院患者样本，对 1999 年至 2015 年期间所有分娩的病例进行回顾性队列研究，以确定患有已知 LMD 的孕妇发生并发症的风险。1999 年至 2015 年间，所有通过国际疾病分类第 9 版编码诊断为 LMD 的孕妇均被确定为 LMD 患者，包括所有纯高胆固醇血症、纯高甘油三酯血症、混合性高脂血症、高乳糜微粒血症和其他脂质代谢紊乱患者。使用非条件逻辑回归分析估计 LMD 对母婴结局的调整影响。
共纳入 13792544 例分娩，其中 9666 例存在 LMD 基础诊断，总患病率为每 10000 例分娩 7.0 例。患有 LMD 的女性更有可能出现妊娠合并糖尿病、高血压和早产，且更易发生心肌梗死、静脉血栓栓塞、产后出血和孕产妇死亡。她们的婴儿发生先天性畸形、胎儿生长受限和胎儿死亡的风险增加。
患有 LMD 的女性发生不良母婴结局的风险显著增加。产前咨询应考虑这些风险，应考虑在专门中心进行产前护理。
