高龄孕妇妊娠期血脂水平变化及与分娩结局的相关性

Abstract
Figure/Table
References
Related Citation (1)

Download: PDF (849 KB) HTML (0 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To determine the normal range of blood lipid levels at different stages of pregnancy for women of advanced maternal age and study the correlations between blood lipid levels and delivery outcomes.Methods (1) The medical records of 5,470 cases of pregnant women of advanced maternalage were screened, who had delivered at Beijing Obstetrics and Gynecology Hospital between January 2018 and December 2019. A total of 834 cases of pregnancy at advanced maternal age were obtained that could be used to establish a reference range for blood lipid levels of pregnant women. The direct method recommended by the Clinical Laboratory Standard Institute (CLSI) in its document C28-A3 was employed to establish the reference range in conjunction with the non-parameter method. (2) The blood lipid levels for different stages of pregnancy among the 5,470 cases of advanced maternal age were inputted into the reference range established above to analyze correlations between the anomaly in blood lipid levels in middle and late pregnancy on one hand and small-for-gestational-age babies,large-for-gestational-age babies,macrosomia and low birth weight babies on the other hand.Results (1)Blood lipid levels at advanced maternal age increased significantly. (2) The reference range of blood lipid levels for advanced maternal age was as follows: total cholesterol (3.169,5.868) mmol/L,triglycerides (0.520,2.016)mmol/L,high density lipoprotein (1.069, 2.131) mmol/L,low density lipoprotein (1.249, 3.488) mmol/L in early pregnancy,total cholesterol(4.690, 8.170) mmol/L,triglycerides(1.120,4.071)mmol/L,high density lipoprotein(1.268, 2.610) mmol/L, low density lipoprotein (1.950, 5.104) mmol/L in middle pregnancy, and total cholesterol (5.210, 8.861) mmol/L,triglycerides (1.658, 5.861) mmol/L, high density lipoprotein (1.240, 2.601) mmol/L, low density lipoprotein (2.129, 5.531) mmol/L in late pregnancy. (3) The decrease of high density lipoprotein in middle pregnancy and increase of triglycerides in late pregnancy were risk factors for large-for-gestational-age babies and macrosomia,while the increase of high density lipoprotein in late pregnancy was a protection factor for large-for-gestational-age babies and macrosomia.The decrease of triglycerides in late pregnancy was a risk factor for low birth weight infants.The rise of high density lipoprotein in late pregnancy was a risk factor for small-for-gestational-age babies for women at advanced maternal age.Conclusions Blood lipid levels at advanced maternal age can increase significantly, so it is necessary to establish different reference ranges. The levels of triglycerides and high density lipoprotein in middle and late pregnancy are closely correlated with delivery outcomes. The correlations between the anomaly in blood lipid level as defined by this study and delivery outcomes has verified the reliability of the reference range.

Key words： advanced maternal age blood lipid metabolism reference range delivery outcome

Received: 02 May 2021

ZTFLH:

R714

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	XING Yu
	WANG Xiaoxin
	ZHANG Weiyuan
	WANG Xin

Cite this article:

XING Yu,WANG Xiaoxin,ZHANG Weiyuan等. Changes in blood lipid levels of pregnant women of advanced maternal age and correlations with delivery outcomes[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2021, 32(8): 681-686.

URL:

http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2021/V32/I8/681

[1]	Herrera E. Lipid metabolism in pregnancy and its consequences in the fetus and newborn [J]. Endocrine, 2002, 19(1): 43-55.
[2]	Herrera E, Ortega-Senovilla H. Lipid metabolism during pregnancy and its implications for fetal growth[J]. Curr Pharm Biotechno, 2014, 15(1):24-31.
[3]	刘伟伟.吉非罗齐参与细胞脂代谢调控的分子作用机制研究[D].上海:东华大学, 2016:1-73.
[4]	应春妹,岳朝艳,张淳义,等.妊娠中、晚期孕妇血脂水平的检测及其正常参考值区间的建立[J].中华妇产科杂志, 2015, 50(12): 926-930.
[5]	徐冬,梁琤,陈璐,等.孕期及产后血脂水平变化及其影响因素的研究[J].中华妇产科杂志, 2018, 53(4): 227-233.
[6]	中国15个城市新生儿科研合作小组.中国15个城市新生儿胎龄和百分位数[J].中华儿科杂志,1989,27:316。
[7]	赵婧晨,杨文双,蒋世菊,等.三种统计学方法在建立妊娠期凝血功能指标参考区间中的应用[J].中华检验医学杂志, 2020, 43(8): 823-830.
[8]	中国成人血脂异常防治指南修订联合委员会.中国成人血脂异常防治指南(2016年修订版)[J].中华心血管病杂志,2016,44(10):833-853.
[9]	刘晓莉,阮炎,刘亚君,等.14省、市、自治区妇女妊娠年龄与妊娠期高血压疾病关系的探讨[J].中华医学杂志, 2015, 95(1): 19-22.
[10]	秦敏,朱蓉,杜莉,等.上海市1996-2015年孕产妇死亡情况分析[J].中华妇产科杂志, 2017, 52(6): 386-391.
[11]	中华医学会妇产科学分会妊娠期高血压疾病学组.高龄妇女妊娠前、妊娠期及分娩期管理专家共识(2019)[J]. 中华妇产科杂志,2019,54(1): 24-26.
[12]	杨慧丽,杨孜.高龄妊娠对母胎结局的影响[J].中华产科急救电子杂志, 2016, 5(3):129-135.
[13]	Herrera E, Ortega-Senovilla H. Maternal lipid metabolism during normal pregnancy and its implications to fetal development[J]. Clin Lipidol, 2010, 5(6): 899-911.
[14]	Lohse Z, Knorr S, Bytoft B, et al. Differential effects of age and sex on insulin sensitivity and body composition in adolescent offspring of women with type 1 diabetes: results from the EPICOM study[J]. Diabetologia, 2018, 61(1): 210-219.
[15]	杨李丽,蒋波,杨年,等.孕期血脂水平、血液流变学与孕妇妊娠结局的关系[J].四川医学,2020,41(5):526-530.
[16]	蒋红清,陈寒,杨静.妊娠期血脂水平的特点及其影响因素[J].中华医学杂志,2016,96(9):724-726.
[17]	Swardfager W, Yu D, Scola G, et al. Peripheral lipid oxidative stress markers are related to vascular risk factors and subcortical small vessel disease [J]. Neurobiol Aging, 2017,59(11):91-97.
[18]	Chen Xinhua, Scholl T O. Maternal biomarkers of endothelial dysfunction and preterm delivery [J]. PLoS One, 2014, 9(1):e85716.
[19]	Sultana Z, Maiti K, Aitken J, et al.Oxidative stress, placental ageing-related pathologies and adverse pregnancy outcomes [J]. Am J Reproduct Immuno, 2017, 77(5): e12653-e12663.
[20]	张幼钗.孕妇糖代谢异常对妊娠结局的影响[J].浙江预防医学,2011,23(1):74-75.
[21]	康倩.妊娠糖尿病患者血清促代谢因子水平与血脂、胰岛素抵抗指数及胰岛β细胞功能指数相关性[J].医学临床研究,2019,36(3):532-534.