不同孕期血脂水平与胎盘重量和胎盘/出生体重比的相关性  

Association between lipid levels at different trimesters and placental weight and placental-to-fetal birth weight ratio

作　　者：廖思静 刘碧玉 沈秋妮 鲜郑钧 李伟 刘一鸣 傅晓冬 LIAO Si-jing;LIU Bi-yu;SHEN Qiu-ni;XIAN Zheng-jun;LI Wei;LIU Yi-ming;FU Xiao-dong(Department of Obstetrics,the Affiliated Hospital of Southwest Medical University,Luzhou 646000;Department of Obstetrics and Gynecology,Pengzhou Maternal and Child Health Hospital,Chengdu 611930;Department of Paediatrics,the Affiliated Hospital of Southwest Medical University,Luzhou 646000,Sichuan,China)

机构地区：[1]西南医科大学附属医院产科,四川泸州646000 [2]彭州市妇幼保健院妇产科,四川成都611930 [3]西南医科大学附属医院儿科,四川泸州646000

出　　处：《川北医学院学报》2024年第8期1041-1044,共4页Journal of North Sichuan Medical College

基　　金：四川省科技厅项目(2021JDR0185);四川省泸州市科技计划项目(2020-SYF-27)。

摘　　要：目的:探讨不同孕期母体空腹血脂与胎盘重量(PW)和胎盘/出生体重比(PFR)的相关性。方法:收集规律产检及足月、顺产分娩的1172例单胎孕妇的基本信息、不同孕期空腹血脂及PW、PFR,分析母体不同孕期空腹血脂对PW、PFR的影响及其与PW和RFR的关系。结果:在排除孕前体质指数(BMI)、孕龄、产次、胎儿性别等混杂因素后,妊娠早期低密度脂蛋白C(LDL-C)每升高1个单位,PW增加9.396 g(95%CI:0.510~18.283,P=0.038);妊娠中期总胆固醇(TC)、甘油三脂(TG)每升高1个单位,PW分别增加8.582 g(95%CI:3.464~13.699,P=0.001)和7.565 g(95%CI:1.825~13.305,P=0.010);载脂蛋白a1(APOA1)每升高1个单位,PW减少31.422 g(95%CI:-49.139~-13.705,P=0.001);妊娠晚期TG每增加1个单位,PW增加5.618 g(95%CI:1.149~10.088,P=0.014);HDL-C每增加1个单位,PW减少18.622 g(95%CI:-30.047~-7.196,P=0.001)。PFR与妊娠晚期APOA1负相关(P<0.05),与妊娠晚期载脂蛋白b(APOB)正相关(P<0.05)。结论:妊娠期母体血脂异常可导致PW、PFR异常,影响胎盘功能及新生儿体重,临床需加强监测母体血脂指标变化并及时干预。Objective:To investigate the association between lipid metabolism at different trimesters and placental weight(PW)and placental-to-fetal birth weight ratio(PFR).Methods:The data of basic information,fasting blood lipid during different trimesters,PW and PFR of 1,172 singleton pregnant women who received regular health care with full-term,natural delivery were collected.The impact of maternal fasting blood lipids on PW and PFR during different pregnancy periods and their relationship with PW and RFR were analyzed.Results:After excluding for pre-pregnancy BMI,gestational age,delivery time and fetal sex,PW was positively correlated with LDL-C in the first trimester,TC,TG in the second trimester,TG in the third trimester,and negatively correlated with APOA1 in the second trimester and HDL-C in the third trimester.PFR was negatively correlated with APOA1 and positively correlated with APOB in the third trimester.Conclusion:Maternal dyslipidemia during pregnancy can lead to abnormal PW and RFR.It is necessary to strengthen monitoring and timely intervention of maternal lipid indexes.

关 键 词：脂代谢 胎盘重量 胎盘/出生体重比 

分 类 号：R714.24[医药卫生—妇产科学]