孕24~28周糖脂代谢紊乱对妊娠并发症和不良妊娠结局的影响分析  

Effects of Glycolipid Metabolism Disorder on Pregnancy Complications and Adverse Pregnancy Outcomes during 24-28 Weeks of Gestation

作　　者：国佳[1] 董微 张爽[1] GUO Jia;DONG Wei;ZHANG Shuang(Women's Health Guidance Department,Tianjin Women's and Children's Health Center,Tianjin 300070,China)

机构地区：[1]天津市妇女儿童保健中心妇保指导科,天津300070

出　　处：《实用妇产科杂志》2023年第3期227-232,共6页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:分析糖脂代谢紊乱对妊娠并发症和不良妊娠结局的影响,探讨孕24~28周单胎孕妇的脂代谢参考范围,以及孕期增加血脂检测的必要性。方法:回顾性分析2019年7月1日至2021年4月30日在天津市妇女儿童保健中心检测75 g口服葡萄糖耐量试验(OGTT)和血脂的1006例孕24~28周单胎孕妇临床资料。选取孕前体质量指数正常且孕期血糖正常的294例孕妇,依据P25和P75制定孕24~28周的血脂参考范围。根据75 g OGTT结果及血脂参考范围,将全部孕妇分为糖脂代谢正常组(n=218)、单纯糖代谢异常组(n=195)、单纯脂代谢异常组(n=333)和糖脂代谢异常组(n=260),分析糖脂代谢异常对妊娠并发症和不良妊娠结局的影响。结果:糖脂代谢异常组中子痫前期、早产、剖宫产、巨大儿和低体质量儿的发生率与糖脂代谢正常组间差异有统计学意义(P<0.05),单纯糖代谢和单纯脂代谢异常组间妊娠并发症和不良妊娠结局差异无统计学意义(P>0.05)。Logistic回归分析提示甘油三酯升高、低密度脂蛋白胆固醇/高密度脂蛋白胆固醇比值升高、空腹血糖受损、糖耐量异常、糖化血红蛋白升高均为妊娠并发症和不良妊娠结局的独立危险因素。结论:对于减少妊娠并发症和不良妊娠结局来说,监测和干预孕期血脂与血糖同样重要。建议在孕24~28周妊娠期糖尿病筛查同时增加血脂检测,血脂的监测对于保障母婴安全具有重要意义。Objective:To analyze the influence of glucose and lipid metabolism disorder on pregnanoy compli-cations and adverse pregnancy outcomes,to explore the reference range of lipid metabolismin singleton pregnant wome n duri ng 24-28 weeks of gestation,a nd to explore the n ecessity of increasi ng blood lipid detectio n during pregnancy.Methods;The clinical data of 1006 singleton pregnant women during 24-28 weeks of gestation who had 75g oral glucose toleranee test(OGTT)and blood lipids in Tianjin Women's and Children's Health Center from July 1 st,2019 to April 30th,2021 were retrospectively analyzed.294 pregnant women with normal pre-preg-nancy BMI and normal blood glucose during pregnancy were selected to establish the reference range of blood lipid between 24 and 28 weeks of gestation according to P_(25)and P_(75).All pregnant women were divided into four groups:normal glucose and lipid metabolism group(n=218),abnormal glucose metabolism group(n=195),ab-normal lipid metabolism group(n=333)and abnormal glucose and lipid metabolism group(n=260)according to OGTT results and blood lipid reference range.The effects of abnormal glucose and lipid metabolism on pregnancy complications and adverse pregnancy outcomes were analyzed.Results:The incidences of preeclampsia,premature delivery,cesarean section,macrosomia and low birth weight in the group with abnormal glucose and lipid metabolism was significantly different from that in the group with normal glucose and lipid metabolism(P<0.05).However,there was no statistical differenee in pregnancy complications and adverse pregnancy outcomes be-tween abnormal glucose metabolism group and abnormal lipid metabolism group(P>0.05).Logistic regression analysis suggested that increased TG,increased LDL-C/HDL-C ratio,impaired fasting blood glucose,impaired glucose tolerance and increased HbA1 c were independent risk factors for pregnancy complications and adverse pregnancy out8mes.Conclusions:To reduce pregnancy complications and adverse perinatal outcomes,it is equally important to m

关 键 词：血糖 血脂 妊娠期 参考范围 妊娠结局 

分 类 号：R714.25[医药卫生—妇产科学]