孕期妇女血脂水平对子代小于胎龄儿影响的前瞻性研究  

Prospective study of maternal lipid profiles and the risk of small for gestational age

作　　者：陈聪 杨梦彤 陈思佳 冯秋雨 陈虹 苏丹萍 郭怡杉 普诗涵 曾果 CHEN Cong;YANG Meng-tong;CHEN Si-jia;FENG Qiu-yu;CHEN Hong;SU Dan-ping;GUO Yi-shan;PU Shi-han;ZENG Guo(Department of Nutrition and Food Hygiene,West China School of Public Health and West China Fourth Hospital,Sichuan University,Chengdu,Sichuan 610041,China)

机构地区：[1]四川大学华西公共卫生学院/华西第四医院营养与食品卫生学系,四川成都610041

出　　处：《现代预防医学》2023年第14期2559-2564,2612,共7页Modern Preventive Medicine

基　　金：达能营养中心膳食营养研究与宣教基金(DIC2016-06)。

摘　　要：目的通过前瞻性队列研究探讨孕期妇女血脂水平对子代小于胎龄儿的影响。方法纳入成都市某医院单胎健康孕妇开展前瞻性随访,通过问卷调查于纳入时收集孕妇基本信息。采用血脂标准检测方法分别在孕早、中、晚期测定血清甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)及高密度脂蛋白胆固醇(HDL-C)水平,根据四分位数法将血脂水平由低到高分为四组(Q1~Q4)。通过医院信息系统收集子代出生体重,计算小于胎龄儿(SGA)发生率。采用多因素非条件logistic回归模型分析孕妇血脂水平对子代小于胎龄儿的影响。结果最终纳入1068例有效样本,SGA发生率为8.1%。孕妇孕早、中、晚期平均血脂水平(mmol/L)分别为:TG 1.32±0.50、2.42±0.97、3.52±1.47,TC 4.14±0.66、5.57±0.94、6.31±1.15,LDL-C 2.04±0.52、3.20±0.85、3.58±1.08,HDL-C 1.67±0.35、1.66±0.31、1.52±0.29。孕晚期TG Q3、Q4组SGA发生风险均较Q1组降低(Q3:OR=0.445,95%CI:0.222~0.891;Q4:OR=0.442,95%CI:0.216~0.904)。孕中期HDL-C Q4组SGA发生风险较Q1组增加(OR=2.103,95%CI:1.113~3.973)。未观察到各孕期TC、LDL-C水平对SGA的影响。结论成都地区孕妇人群TG、TC、LDL-C随孕期增加呈升高趋势、HDL-C呈下降趋势。孕期TG、HDL-C水平与SGA发生风险有关,TG水平升高可能降低SGA发生风险,HDL-C水平升高可能增加SGA发生风险,尚需进一步研究确认。建议加强孕妇孕期血脂监测,以减少不良妊娠结局。Objective To investigate the effect of maternal lipid profiles on small for gestational age during pregnancy:a prospective study.Methods Healthy pregnant women with singleton pregnancies in Chengdu hospital were selected as the study population and followed up until delivery.Basic maternal information was collected at the time of inclusion through a questionnaire.Serum triglyceride(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C)and high-density lipoprotein cholesterol(HDL-C)levels were measured at early,middle,and late pregnancy using standard lipid testing methods,and lipid levels were divided into four groups(Q1-Q4)according to the quartile method.Birth weight of newborns was collected through the hospital information system and the incidence of small for gestational age(SGA)was calculated.A multi-factor unconditional logistic regression model was used to analyze the effect of maternal lipid profiles on small for gestational age.Results A final valid sample of 1068 cases were included,with an SGA incidence of 8.1%.The mean maternal lipid profiles levels(mmol/L)in early,middle,and late pregnancy were TG 1.32±0.50,2.42±0.97,3.52±1.47,TC 4.14±0.66,5.57±0.94,6.31±1.15,LDL-C 2.04±0.52,3.20±0.85,3.58±1.08,HDL-C 1.67±0.35,1.66±0.31,1.52±0.29.The risk of SGA in late pregnancy was reduced in both TG Q3 and Q4 groups compared to Q1 group(Q3:OR=0.445,95%CI:0.222-0.891;Q4:OR=0.442,95%CI:0.216-0.904).There was an increased risk of SGA in middle pregnancy HDL-C Q4 group compared to the Q1 group(OR=2.103,95%CI:1.113-3.973).No effect of TC and LDL-C levels on SGA were observed during pregnancy.Conclusion Maternal lipid profiles levels in the pregnant population in Chengdu show an increasing trend in TG,TC and LDL-C and a decreasing trend in HDL-C with increasing gestation.TG and HDL-C levels are associated with the risk of SGA during pregnancy,and an increase in TG levels may reduce the risk of SGA,while an increase in HDL-C levels may increase the risk of SGA.It is recommended that maternal li

关 键 词：孕妇 血脂 小于胎龄儿 

分 类 号：R173[医药卫生—妇幼卫生保健]