The Change Of Blood Lipid Level In Macrosomia Pregnant Women And Its Clinical Significance

Object:Macrosomia is defined as infant whose birth weight ?4000 g,and is associated with several maternal and fetal complications.In recent years,with the improvement of living standards,the problems of prenatal over nutrition increased,leading the incidence of macrosomia rising year by year.It is time to strengthen the prevention and prenatal screening of macrosomia.In addition to the hyperglycemia,genetic,pregnancy history,gestational weeks,pre-pregnancy weight and gestational weight gain(GWG)have significant impact on the occurrence of macrosomia.This study aimed to explore the influence factors of macrosomia through the analysis of the information of macrosomia pregnant women and lipid levels during pregnancy,and further put forward effective measures to reduce the incidence of macrosomia.Methods:This is a retrospective control study of women who regular antenatal cared and delivered in the Women's Hospital School of Medicine Zhejiang University from January 2014 to December 2014.Excluding those test-tube baby,twins or multiple births,low birth weight,and complications before or during pregnancy,a total of 7310 women were taken into the study.The experimental group consisted of 413 pregnant women who delivered macrosomia,and the control group consisted of 6897 pregnant women who delivered normal birth weight infant.The variables were obtained from medical records,including age,pregnancy history,pre-pregnancy BMI(pre-BMI),GWG,gestational weeks and lipid level during pregnancy.The experimental group was classified according to the age,pregnancy history,pre-BMI and GWG,respectively analyzing blood lipid level between different groups.Evaluate the influence factors of fetal macrosomia through binary logistic regression analysis.Results:1.The age,GWG,gestational weeks of experimental group were greater than the control group(29.5�3.5y vs.29.1�3.3y,16.63�4.44kg vs.14.65�3.93kg,40�1.6wk vs.39�1.3wk,P<0.05).The pregnancy history and pre-BMI had no significant difference(P>0.05).2.The TG during second trimester and late pregnancy of experimental group were greater than the control group(2.32�0.85mmol/L vs.2.15�0.84mmol/L,3.85�1.70mmol/L vs.3.32�1.65mmol/L,P<0.05).The TG during second trimester and late pregnancy of experimental group were lower than the control group(2.29�0.48mmol/L vs.2.41�0.66mmol/L,1.94�0.46mmol/L vs.2.15�0.59mmol/L,P<0.05).The TC and LDL had no significant difference(P>0.05).3.The TG during second trimester of>35y group was greater than that of<25y group,25-29y group and 30-34y group(2.72�0.83mmol/L vs.2.02�0.49mmol/L,2.23�0.71mmol/L and 2.39�1.00mmol/L,P<0.05);that of 30-34y group was also greater than<25y group(P<0.05).The TG during late pregnancy of 30-34y group and>35y group were both greater than that of<25y group and 25-29y group(4.06�1.92mmol/L vs.3.14�0.98mmol/L and 3.65�1.49mmol/L,4.49�1.80mmol/Lvs.3.14�0.98mmol/L and 3.65�1.49mmol/L,P<0.05).4.The TG during second trimester of multipara group was greater than that of primipara group(2.49�0.97mmol/L vs.2.25�0.79mmol/L,P<0.05).The TG during late pregnancy had no significant difference(P>0.05).5.Binary logistic regression analysis revealed that age(OR=1.072,95%CI 1.040-1.105,P<0.05),GWG(OR=1.108,95%CI 1.083-1.134,P<0.05),gestational weeks(OR= 1.676,95%CI 1.521-1.847,P<0.05),TG during late pregnancy(OR=1.067,95%CI 1.011-1.127,P<0.05),HDL during late pregnancy(OR=0.496,95%CI 0.372-0.660,P<0.05)were significantly associated with the incidence of macrosomia.Conclusion:1.As maternal age,GWG,gestational weeks and TG during pregnancy increase,the incidence of macrosomia increases;2.The macrosomia pregnant women TG level associated with maternal age and time,elderly primiparas have higher TG;3.In normal pregnancy,maternal age,GWG,gestational weeks and TG during late pregnancy are risk factors for macrosomia,while HDL during late pregnancy is a protective factor of that.4.It is beneficial for reducing the incidence of macrosomia to strengthen the management of nutrition care and control weight gain during pregnancy.Moreover,timely termination of pregnancy is a effective measure to lower the risk of macrosomia,ensuring maternal and child health.