Relationship Between Excessive Weight Gain During Pregnancy And Serum Inflammatory Factors,glucose And Lipid Metabolism And Perinatal Outcomes

Objectives To explore the relationship between excessive weight gain during pregnancy and changes in serum inflammatory factors,glucose and lipid metabolism and perinatal outcomes for pregnant women,and to provide a theoretical basis for reasonable weight control during pregnancy and reducing adverse pregnancy outcomes.Methods Pregnant women who were filed and delivered in the affiliated hospital of North China University of Science and Technology from 2018.11 to 2019.05 were taken as subjects.According to the 2009 IOM recommended rate of weight gain in the third trimester of pregnancy and weight gain during pregnancy,pregnant women were divided into two groups: 45 cases of excessive weight gain group and 41 cases of moderate group.Before delivery,3ml～5ml of fasting cubital venous blood was collected from two groups of pregnant women,and 2ml of umbilical artery blood of two groups of neonates was collected within 1 minute after omphalotomy.The blood glucose,blood lipid levels,highsensitivity C-reactive protein levels in maternal blood,and PCO₂,p H,and lactate content in neonatal umbilical artery blood were detected.Meanwhile,the expression levels of IL-8,IL-6 and TNF-α in serum of two groups of pregnant women were detected by elasa method.The levels of serum inflammatory factors,glucose and lipid metabolism,complications during pregnancy and adverse pregnancy outcomes were compared between the two groups,and the related indicators of neonatal development were compared.Results 1 Comparison of general basic data（age,education level,gestational week,pregnancy,parity,pre-pregnancy BMI,etc.）between the two groups of pregnant women showed no significant difference（P>0.05）.2 The mean comparison of serum inflammatory factors between the two groups of pregnant women,the results are as follows: IL-6（0.64±0.36,0.45±0.23）ng/L,IL-8（0.44±0.27,0.33±0.18）pg/ml,TNF-α（0.49±0.37,0.35±0.20）pg/ml,CRP（4.75±2.89,3.57±1.97）m g / L.The level of inflammatory factors in over weight gain group was higher than that in moderate weight gain group,the difference is statistically significant（P<0.05）.3 Comparison of the average levels of glycolipids between the two groups,the results are as follows: total cholesterol（6.75±0.85,6.21±1.02）mmol/L,triglyceride（3.69±1.19,2.97±1.11）mmol/L,high-density lipoprotein（2.16±0.41,1.97±0.42）mmol/L and apolipoprotein A（2.30±0.25,2.10±0.35）g/L,excessive weight gain and recombination are higher than the moderate weight gain group,low density lipoprotein（3.63±0.67,4.06±0.93）mmol/L,apolipoprotein B（1.26±0.33,1.42±0.32）g/L,excessive weight gain Below the moderate weight gain group,the differences were statistically significant（P<0.05）.Compared with fasting blood glucose between the two groups（P>0.05）.4 Fasting cholesterol（OR=2.959,95%CI: 1.121～6.008,P=0.026）,triglyceride（OR=2.461,95%CI: 1.254～4.832,P<0.01）,apolipoprotein B（OR=0.385,95%CI: 0.170～0.873,P=0.022）and hypersensitive C-reactive protein（OR=2.306,95%CI: 1.239～4.293,P<0.01）are independent risk factors for excessive weight gain during pregnancy.5 Compared with perinatal uterine height（35.27±2.05,33.83±2.24）cm,abdominal circumference（105.49±6.03,97.83±4.92）cm,placental weight（673.43±138.88,615.00±77.00）g,and neonatal weight（3520.67±399.83,3233.66±327.71）g,the overweight group was higher than the moderate weight group,the difference was statistically significant（P<0.05）.6 The incidence of premature rupture of membranes,cesarean section rate,and the incidence of giant children in the overweight group（37.8%,40.0%,20.0%）were higher than those in the moderate weight gain group（12.2%,14.6%,2.5%,P<0.05）.7 The lactic acid value in the umbilical artery blood of the moderate weight gain group was lower than that of the overweight group（6.93±2.58,8.09±2.22）mmol/L,and the p H value was higher than that of excessive weight gain（7.20±0.92,7.16±0.68,P<0.05）.The incidence of fetal distress and neonatal umbilical artery blood PCO₂ were not statistically significant between the two groups（P>0.05）.8 The incidence of giving birth intervention（42.2%）in the overweight group was higher than that in the moderate group（14.6%）,the difference was statistically significant（P<0.05）.Conclusions 1 The level of serum inflammatory factors in pregnant women with excessive weight gain is higher,which aggravates the inflammatory state during pregnancy.2 Excessive weight gain during pregnancy causes disorder of glucose and lipid metabolism.3 Maternal plasma,triglyceride,apolipoprotein B and hypersensitive C-reactive protein are independent risk factors for excessive weight gain during pregnancy.4 Excessive weight gain during pregnancy is more likely to give birth to large children.5 Excessive weight gain during pregnancy increases labor intervention and the probability of adverse perinatal outcomes,which may also increase the risk of neonatal acidosis.Figure 0;Table 8;Reference 199...