国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2018, Vol. 37 ›› Issue (5): 377-381.

• 论著 • 上一篇    下一篇

产次对孕妇血脂及妊娠并发症的影响

罗梦梦，尹晓茜，胡小月，龚淼，刘素新，霍琰   

  1. 063210  唐山，华北理工大学附属河北省人民医院（罗梦梦）；河北北方学院研究生院（尹晓茜）；河北省人民医院产科（胡小月，龚淼，刘素新，霍琰）
  • 收稿日期:2018-06-06 修回日期:2018-07-28 出版日期:2018-09-15 发布日期:2018-09-15
  • 通讯作者: 霍琰，E-mail：hy196867@126.com E-mail:hy196867@126.com

Influence of Different Parity on Serum Lipid during Pregnancy and Pregnant Outcome

LUO Meng-meng，YIN Xiao-qian，HU Xiao-yue，GONG Miao，LIU Su-xin，HUO Yan   

  1.  Hebei People′s Hospital Affiliated to North China University of Science and Technology，Tangshan 063210，Hebei Province，China（LUO Meng-meng）；Graduate School of Hebei North University，Zhangjiakou 075000，Hebei Province，China（YIN Xiao-qian）；Obstetrics Department，Hebei General Hospital，Shijiazhuang 050000，Hebei Province，China（HU Xiao-yue，GONG Miao，LIU Su-xin，HUO Yan）
  • Received:2018-06-06 Revised:2018-07-28 Published:2018-09-15 Online:2018-09-15
  • Contact: HUO Yan，E-mail：hy196867@126.com E-mail:hy196867@126.com

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摘要： 目的：探讨不同产次对孕妇血脂及妊娠并发症的影响。方法：收集2016年9月—2017年12月在河北省人民医院产检并分娩的孕妇共1 669例，按孕周及年龄分为4组：妊娠中期适龄组527例、妊娠中期高龄组261例、妊娠晚期适龄组636例、妊娠晚期高龄组245例，其中每组根据产次分为初产妇和经产妇，比较各组血脂水平、高密度脂蛋白胆固醇（HDL-C）/总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）/TC、LDL-C/HDL-C比值以及妊娠结局。结果：①妊娠中期适龄组经产妇（与初产妇比较）三酰甘油（TG）、TC和极低密度脂蛋白胆固醇（VLDL-C）水平明显升高（P＜0.05）；妊娠中期高龄组经产妇（与初产妇比较）TG、TC、HDL-C、LDL-C、VLDL-C和HDL-C/TC水平呈升高趋势，但仅HDL-C水平差异有统计学意义（P＜0.05）。②妊娠晚期适龄组经产妇（与初产妇比较）LDL-C、VLDL-C、LDL-C/TC和LDL-C/HDL-C水平显著降低，而HDL-C/TC升高（均P＜0.05）；妊娠晚期高龄组经产妇（与初产妇比较）TG、TC、HDL-C、LDL-C、HDL-C/TC和LDL-C/HDL-C水平呈下降趋势，VLDL-C水平升高，但差异均无统计学意义（P＞0.05）。③与初产妇相比，适龄组经产妇胎膜早破及胎儿窘迫的发病率下降，高龄组妊娠期高血压疾病（HDCP）和妊娠期糖尿病（GDM）、胎儿窘迫发生率下降（P＜0.05）；而适龄组经产妇早产儿和巨大儿发生率升高（P＜0.05）。④高龄组GDM和HDCP发生率高于适龄组（P＜0.05）。结论：产次对血脂有一定程度的影响，可导致妊娠并发症的发生。

关键词: 孕妇, 产次, 血脂异常, 妊娠结局

Abstract: Objective：To investigate the influence of parity on serum lipid during pregnancy and pregnant outcome. Methods：Totally, 1 669 women who delivered in Hebei General Hospital from September 2016 to December 2017 were recruited. Those women were divided into four groups based on the age and gestational age: the right-age and mid-pregnancy group (527 cases), the advanced-age and mid-pregnancy group (261 cases), the right-age and late-pregnancy group (in the late of pregnancy, 636 cases), the advanced-age and late-pregnancy group (in the late of pregnancy, 245 cases). Each group was divided into two subgroups: the primipara subgroup and the multipara subgroup according to the number of births. The levels of serum lipid, HDL-C/TC, LDL-C/TC and the LDL-C/HDL-C ratio were compared. Results：①The levels of TG, TC, VLDL-C in multipara women of the right-age and mid-pregnancy group were significantly increased (all P＜0.05), while the levels of TG, TC, HDL-C, LDL-C, VLDL-C and HDL-C/TC in multipara women of the advanced-age and mid-pregnancy group were mildly increased, only the significant difference in HDL-C level (P＜0.05), when compared with those primipara women. ②The levels of LDL-C, VLDL-C, LDL-C/TC and LDL-C/HDL-C in multipara women of the right-age and late-pregnancy group were significantly decreased, and the level of HDL-C/TC increased (all P＜0.05), while the levels of TG, TC, HDL-C, LDL-C, HDL-C/TC and LDL-C/HDL-C in multipara women of the advanced-age and late-pregnancy group were mildly decreased  (but P＞0.05) and the level of VLDL-C mildly increased (but P＞0.05), when compared with those primipara women. ③Compared with those primipara women, the multipara women of the right-age groups had lower incidences of premature rupture of membranes and fetal distress, while the multipara women of the advanced-age groups had lower incidences of hypertensive disorder complicating pregnancy (HDCP), gestational diabetes mellitus (GDM) and fetal distress (all P＜0.05). However, the incidences of premature and giant babies in those multipara women of the right-age groups were higher than those in the primipara women (both P＜0.05). ④The incidences of HDCP and GDM in both advanced-age groups were significantly higher than those in both right-age groups (all P＜0.05). Conclusions：Parity has a certain degree of effect on serum lipids, which could be related to pregnancy complications.

Key words: Pregnant women, Parity, Dyslipidemias, Pregnancy outcome