Department of Obstetrics and Gynecology, The Affiliated Hospital of Chengde Medical University, Chengde, 067000, PR China.
Department of Preventive Medicine, Chengde Medical University, Chengde, 067000, PR China.
Lipids Health Dis. 2023 Feb 1;22(1):18. doi: 10.1186/s12944-023-01781-8.
To investigate the correlation between maternal glucose and lipid metabolism indexes and blood-lipid ratio in the first trimester and large-for- gestational-age (LGA) infants.
Women in the first trimester of pregnancy who underwent regular obstetric examination in the obstetric outpatient department of the Affiliated Hospital of Chengde Medical College from June 2018 to March 2019 were included according to the standard. Basic information were collected based on questionnaires at the first visit of pregnant women, including early fasting blood glucose (FBG), fasting insulin (FINS), glycated hemoglobin (HbA1c), high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglyceride (TG), total cholesterol (TC), apolipoprotein A1 (APO-A1), apolipoprotein B (APO-B), lipoprotein a (LP(a)), LDL/HDL, TG/HDL, TC/HDL, APO-B/APO-A1 ratio, birth weight of newborns, gestational age at delivery etc. RESULTS: A total of 418 cases were included for analysis. The incidence rate of LGA infants was 13.88%, and that of small-for-gestational-age (SGA) infants was 4.78%. Univariate analysis revealed that the age, pre-pregnancy body mass index (BMI), weight gain during pregnancy, APO-B/APO-A1 between LGA group and appropriate-for-gestational-age (AGA) group were significantly different (P < 0.05); multivariate stepwise logistic regression analysis indicated that the correlation between maternal age, pre-pregnancy BMI, weight gain during pregnancy, APO-B/APO-A1 level and LGA were statistically significant (P < 0.05); compared with the reference range of APO-B/APO-A1 of 0.46-0.65, values < 0.46 and > 0.65 were protective factor of LGA (P < 0.05). The receiver operating curve(ROC) indicated that the area under the curve (AUC)s for predicting LGA using maternal age, pre-pregnancy BMI, weight gain during pregnancy, and early pregnancy APO-B/APO-A1 were 0.585, 0.606, 0.637, 0.531, respectively. The AUC for a combined prediction model was 0.742, showing greater predictive value than any other factors individually.
Maternal age, pre-pregnancy BMI, weight gain during pregnancy, and APO-B/APO-A1 levels in first trimester are significant factors influencing the occurrence of LGA infants, and the combination of the four factors would have certain predictive value for LGA.
探讨孕妇孕早期血糖、血脂代谢指标与巨大儿（LGA）的相关性。
选择 2018 年 6 月至 2019 年 3 月在承德医学院附属医院产科门诊行常规产检的孕妇，根据纳入标准，收集孕妇首次就诊时的基本信息问卷，包括早期空腹血糖（FBG）、空腹胰岛素（FINS）、糖化血红蛋白（HbA1c）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、三酰甘油（TG）、总胆固醇（TC）、载脂蛋白 A1（APO-A1）、载脂蛋白 B（APO-B）、脂蛋白 a（LP(a)）、LDL/HDL、TG/HDL、TC/HDL、APO-B/APO-A1 比值、新生儿出生体重、分娩孕周等。
共纳入 418 例孕妇进行分析，LGA 发生率为 13.88%，SGA 发生率为 4.78%。单因素分析发现，LGA 组与 AGA 组的年龄、孕前 BMI、孕期体重增加、APO-B/APO-A1 比较，差异均有统计学意义（P<0.05）；多因素逐步 Logistic 回归分析显示，孕妇年龄、孕前 BMI、孕期体重增加、APO-B/APO-A1 与 LGA 存在相关性，差异有统计学意义（P<0.05）；与 APO-B/APO-A1 的参考范围 0.46-0.65 比较，<0.46 和>0.65 是 LGA 的保护因素（P<0.05）。受试者工作特征曲线（ROC）分析显示，年龄、孕前 BMI、孕期体重增加、孕早期 APO-B/APO-A1 预测 LGA 的曲线下面积（AUC）分别为 0.585、0.606、0.637、0.531，联合预测模型的 AUC 为 0.742，预测价值均优于各因素单独预测。
孕妇孕早期年龄、孕前 BMI、孕期体重增加、APO-B/APO-A1 水平是影响 LGA 发生的显著因素，四者联合对 LGA 有一定的预测价值。
