孕妇年龄与甘油三酯对巨大儿的联合影响  

Joint effects of maternal age with triglycerides on macrosomia

作　　者：林桂梅 陶建英 Lin Guimei;Tao Jianying(Department of Obstetrics,the Affiliated Suzhou Hospital of Nanjing Medical University,Suzhou Municipal Hospital,Suzhou 215006)

机构地区：[1]南京医科大学附属苏州医院产科,苏州215006

出　　处：《现代妇产科进展》2023年第6期430-434,共5页Progress in Obstetrics and Gynecology

摘　　要：目的:探讨孕妇年龄与甘油三酯(TG)对巨大儿的联合影响。方法:回顾分析2018年1月至2018年12月于南京医科大学附属苏州医院产科分娩的2127例产妇。根据新生儿出生体重,分为巨大儿组(出生体重≥4000g)及对照组(出生体重2500g~<4000g),按孕妇年龄(<32岁,≥32岁)或TG水平分组[Q1(≤2.07mmol/L),Q2(≤2.51 mmol/L),Q3(≤3.04mmol/L),Q4(≤3.78mmol/L),Q5(≤33.2mmol/L)],评估孕妇年龄、TG在巨大儿中的交互作用。结果:与参考组(年龄<32岁合并TG位于Q1水平组)相比,经多变量因素调整后,单纯年龄增高组巨大儿的OR(95%CI)为1.08(0.55~2.13);单纯TG增高组[Q2、Q3、Q4、Q5]的OR(95%CI)分别为1.38(0.90~2.12)、1.51(0.97~2.35)、2.24(1.46~3.44)和2.71(1.62~4.52);年龄合并TG均增高组的OR(95%CI)分别为1.62(0.84~3.14)、1.34(0.73~2.46)、3.69(2.01~6.79)和4.94(2.73~8.96),从TG的Q3开始,OR呈上升趋势。在TG的Q5水平,两个危险因素相加交互作用产生的相对超额危险度(RERI)为2.31(0.07~4.55),表明孕妇年龄和TG在巨大儿风险中存在相加交互作用。结论:在健康孕妇人群中,同时患有孕妇高年龄水平及高TG水平的患者发生巨大儿的风险超过单独患有两者之和。Objective:To explore the joint effects of maternal age and triglycerides on macrosomia.Methods:2127 pregnant women delivered in Department of Obstetrics,Suzhou Hospital Affiliated to Nanjing Medical University were retrospectively analyzed.According to the birth weight of newborns,they were divided into macrosomia group(birth weight≥4000g)and control group(birth weight between 2500g~<4000g).All subjects were grouped by maternal age(<32 years old,≥32 years old)or triglyceride levels[Q1(≤2.07mmol/L),Q2(≤2.51 mmol/L),Q3(≤3.04mmol/L),Q4(≤3.78mmol/L),Q5(≤33.2mmol/L)]and analyzed to assess the interaction of maternal age and TG on macrosomia.Results:Compared with reference group(maternal age<32 years and TG levels in Q1),multivariable-adjusted analysis showed that the OR(95%CI)of macrosomia for the higher maternal age alone was 1.08(0.55~2.13),that the OR(95%CI)of higher TG levels alone in Q2~Q5 were 1.38(0.90~2.12)、1.51(0.97~2.35)、2.24(1.46~3.44)and 2.71(1.62~4.52),respectively.The OR(95%CI)for both the higher maternal age and higher TG levels were 1.62(0.84~3.14)、1.34(0.73~2.46)、3.69(2.01~6.79)and 4.94(2.73~8.96),respectively.The multivariable-adjusted OR started to accelerate from Q3 of TG.Relative excess risks(RERI)due to interaction was 2.31(0.07~4.55),confirming the presence of additive interactions between maternal age and TG on macrosomia.Conclusions:The risk of macrosomia in healthy pregnant women from joint exposure of the higher maternal age and elevated TG was much higher than the sum of the separate risks of exposing to higher maternal age or elevated TG.

关 键 词：产妇年龄 甘油三酯 巨大儿 出生体重 

分 类 号：R714.2[医药卫生—妇产科学]