不同妊娠阶段血脂水平变化与早产结局的关联研究  

Study on the relationship between the changes of serum lipid levels and the outcome of preterm delivery in different stages of pregnancy

作　　者：刘文波 王燕侠[2] 焦新娟 韩茜 刘东海[2] LIU Wen-Bo;WANG Yan-Xia;JIAO Xin-Juan(Gansu University of Traditional Chinese Medicine,Lanzhou,Gansu 730000,China)

机构地区：[1]甘肃中医药大学,甘肃兰州730000 [2]甘肃省妇幼保健院,甘肃兰州730000

出　　处：《中国妇幼保健》2022年第13期2361-2364,共4页Maternal and Child Health Care of China

基　　金：甘肃省科技计划项目—创新基地和人才计划(20JR10RA427,20JR10RA428,18JR2FA004)。

摘　　要：目的 对比分析早产与正常产产妇的孕早、中、晚期血脂水平变化差异,探讨全孕程血脂变化与早产结局关联。方法 整群抽样选取2018年6月—2020年6月在甘肃省妇幼保健院产科住院的无基础代谢及妊娠合并症疾病史的早产单胎产妇作为病例组,以体质指数(BMI)作为匹配条件,按照1∶2匹配正常分娩健康单胎孕妇作为正常对照组开展病例对照研究,收集分娩结局信息资料,回顾性调查并记录两组孕产妇孕早、中、晚期血脂指标,包括三酰甘油、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇及总胆固醇等,通过单因素及多因素分析孕期血脂水平变化对早产结局的影响。结果 研究共纳入268例早产病例及525例正常对照开展研究,多因素逻辑回归结果发现,居住于乡村(OR=2.651,95%CI:1.755~4.004)、孕晚期三酰甘油高水平(OR=0.023,95%CI:1.170~7.812)和孕晚期胆固醇低水平(OR=3.130,95%CI:1.410~6.946)是早产的危险因素;孕中期胆固醇高水平(OR=0.116,95%CI:0.031~0.436)是早产的保护性因素。结论 孕晚期三酰甘油和胆固醇高水平会增加早产发病风险,应加强孕期血脂水平监测,及时实施饮食、运动等干预手段降低血脂,预防早产发生,促进母婴安全。Objective To compare and analyze the changes of blood lipid levels in early, middle and late pregnancy between preterm and normal parturient women, and to explore the association between the changes of blood lipid levels in the whole pregnancy and the outcome of preterm delivery.Methods cluster sampling in June 2018 to June 2020 in gansu province maternity hospital maternity and children’s health care centers with no history of basal metabolism and pregnancy complications disease premature singletons as cases, maternal BMI as matching conditions 1∶2 matched healthy single normal childbirth pregnant women as normal control group to carry out the case-control study, collect information delivery end, The two groups were retrospectively investigated and recorded early, middle and late blood lipid indexes, including triglyceride, low density lipoprotein, high density lipoprotein, total cholesterol, etc.to analyze the influence of changes in blood lipid levels during pregnancy on the outcome of preterm delivery through univariate and multivariate factors.Results A total of 268 cases of preterm birth and 525 normal controls were included in the study.Multivariate logistic regression showed that living in rural areas(OR=2.651,95%CI:1.755-4.004) was associated with higher triglyceride levels in late pregnancy(OR=3.023,95%CI:1.170-7.812) and low cholesterol during the third trimester(OR=3.130,95%CI:1.410-6.946) were risk factors for preterm birth;High cholesterol level in the second trimester(OR=0.116,95%CI:0.031-0.436) and low triglyceride level in the third trimester(OR=0.311,95%CI:0.115-0.841) were protective factors for preterm birth.Conclusion The high levels of triglyceride and cholesterol in late pregnancy may increase the risk of premature delivery.It is necessary to strengthen the monitoring of blood lipid levels during pregnancy and timely implement interventions such as diet and exercise to reduce blood lipid levels, prevent the occurrence of premature delivery and promote the safety of mothers and infants.

关 键 词：妊娠 血脂 胆固醇 三酰甘油 脂蛋白 早产 

分 类 号：R714.7[医药卫生—妇产科学]