| Objective: To analyze the characteristics of fat metabolism in pregnant women with gestational diabetes mellitus(GDM)during pregnancy,and to explore the influencing factors and adverse complications of abnormal lipid metabolism in GDM by establishing the reference range of normal gestational lipid in our hospital.Methods: A retrospective analysis was performed on 530 pregnant women with GDM(GDM group)and 530 normal pregnant women(control group)who received regular antenatal check-up and delivered in Maternal and Child Health Hospital Affiliated to Anhui Medical University from January 2021 to June 2022.The blood lipid levels and changes of GDM pregnant women were compared with normal pregnant women in the first,second and third trimesters.The control group was used to establish the reference range of normal pregnancy blood lipid in our hospital to determine whether the complication of lipid metabolism was abnormal.Multivariate regression was used to analyze the influencing factors of abnormal lipid metabolism in pregnant women with GDM and the influence of abnormal lipid metabolism complicated by GDM on adverse complications of mother and child.Results:1.The TG,TC,HDL and LDL of pregnant women with GDM increased throughout pregnancy,TC and TG in early pregnancy.TC,TG and LDL of pregnant women with GDM in the second and third trimester were higher than normal pregnant women,the HDL of pregnant women with GDM in early,second and third trimester was lower than those of normal pregnant women,and the difference was statistically significant(P <0.05).2.The reference interval was established for normal pregnant women in our hospital.,and the critical value of blood lipid was as follows:First trimester: TC < 4.66 mmol/L,TG < 1.63 mmol/L,HDL > 1.33 mmol/L,LDL < 3.06 mmol/L;Second trimester:TC <5.69 mmol/L,TG < 3.04 mmol/L,HDL > 1.43 mmol/L,LDL < 3.82 mmol/L;Third trimester:TC < 7.40 mmol/L,TG < 4.12 mmol/L,HDL > 1.90 mmol/L,LDL <4.34mmol/L.3.Risk factors for gestational diabetes mellitus complicated with abnormal lipid metabolism included: advanced age(OR=6.300,95%CI: 1.075-36.936,P=0.041),prepregnancy overweight and obesity(OR=11.667,95%CI: 1.139-119.542,P=0.039),excessive weight gain during pregnancy(OR=2.664,95%CI: 1.182-6.002,P=0.018).4.The cluster analysis of risk factors obtained by multiple Logistic regression was carried out.Pregnant women who were not exposed to old age,overweight and obese before pregnancy,and excessive weight gain during pregnancy were taken as the control group,the number of exposure risk factors was 1(OR=9.081,95%CI: 1.070-77.085,P=0.044)and 2(OR=14.769,95%CI: 1.518-143.728,P=0.019)and 3(OR=19.200,95%CI: 1.468-251.138,P=0.044)were closely correlated with abnormal lipid metabolism in pregnant women with gestational diabetes mellitus.5.The birth weight and cesarean section rate of GDM pregnant women with abnormal lipid metabolism were higher than those of GDM pregnant women with normal lipid metabolism.The number of labor weeks in GDM pregnant women with abnormal lipid metabolism was lower than that in GDM pregnant women with normal lipid metabolism,and the difference between the two groups was statistically significant(P < 0.05).6.The incidence of preeclampsia,premature delivery and macrosomia in GDM pregnant women with abnormal lipid metabolism were higher than those in GDM pregnant women with normal lipid metabolism,and the difference between the two groups was statistically significant(P < 0.05).Conclusions:The level of blood lipid in GDM pregnant women was higher and increased during pregnancy.Establish reasonable reference range of normal blood lipid in our hospital..Advanced age,pre-pregnancy overweight and obesity,excessive weight gain during pregnancy are independent risk factors for abnormal lipid metabolism in pregnant women with gestational diabetes.With the accumulation of independent risk factors,the incidence of maternal and infant adverse complications increases,which provides the basis for clinical diagnosis and treatment. |
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