Study On The Blood Lipid Level In Late Pregnancy And Its Clinical Significance In Macrosomia Pregnant Women

Objective:To study the relationship between maternal serum total cholesterol(TC),triglyceride cholesterol(TG),high-density lipoprotein(HDL),low-density lipoprotein(LDL)in late pregnancy and the occurrence of macrosomia and its clinical significance.To provide reference to reduce the incidence of macrosomia and avoid adverse maternal and infant pregnancy outcomes.Methods:A total of 228 cases of macrosomia pregnant women who met the inclusion criteria and gave birth in obstetrics and gynecology of Subei People’s Hospital of Jiangsu Province from January 2017 to December 2020 were included in the macrosomia group(neonate weight≥4000g),we collected 228 pregnant women who delivered in our hospital at the same time and their neonate weight was between 2500-3999g as the control group,we collected their clinical data and compared retrospectively,such as age,BMI before pregnancy,weight gain during pregnancy,postpartum complications during delivery,differences in delivery methods,and neonatal conditions such as sex and weight of the newborn,etc,to study the correlation between four blood lipid indexes and the occurrence of macrosomia and its clinical significance.Result:1.Comparison of the basic data of the two groups:In the macrosomia group,the weight gain during pregnancy(GWG),gestational week were significantly greater than those of the control group(P<0.05).There was no significant difference in pre-pregnancy BMI,gender of the newborns,maternal age,history of pregnancy and delivery(P>0.05).2.Comparison of pregnancy complications and pregnancy outcomes of the two groups:The r ates of cesarean section,GDM,cephalopelvic disproportion,shoulder dystocia,lateral perine al resection,neonatal hypoglycemia in the macrosomia group were significantly higher(P<0.05).Although the proportions of premature rupture of membranes and postpartum hemorrh age in the macrosomia group were higher,the differences were not statistically significant(P>0.05).3.Comparison of blood lipid levels in the third trimester of pregnancy between the two groups:The TG and TC levels in the macrosomia group were significantly higher,and the HDL levels were significantly lower than those in the control group(p<0.05).The mean level of LDL in the macrosomia group was slightly higher,but there was no significant difference(p>0.05).4.Logistic regression analysis of factors related to macrosomia:GWG(OR=1.198,95%CI=1.049-1.150),gestational week of delivery(OR=1.564,95%CI=1.221-2.004),high TG in the third trimester(OR=1.629,95%CI=1.257-2.113)are independent risk factors for macrosomia(P<0.05).The risk was negatively correlated(OR=0.241,95%CI=0.119-0.488 P<0.001).TC in the third trimester is not an independent risk factor for macrosomia(P>0.05).5.Relevant factors during pregnancy and the ROC curve of macrosomia:The area under the ROC curve of TG to macrosomia during the third trimester is 0.671(95%CI=0.622-0.720),and the best cut-off value is 2.86mmol/L,which has diagnostic value(P<0.05),the area under the ROC curve of HDL level for macrosomia is 0.634(95%CI=0.583-0.686),the best cut-off value is 1.60mmol/L,which has diagnostic value(P<0.05).The adjusted area under the combined curve is 0.788,which has a moderate diagnostic value(P<0.05).6.Comparison of blood lipid index levels between the GDM group and the non-GDM group in the macrosomia group:According to whether the pregnant women had GDM during pregnancy,the macrosomia pregnant women are divided into the macrosomia GDM group and the macrosomia without GDM group.The level of TG in the third trimester of pregnancy and the weight of newborns in the GDM group of macrosomia are significantly higher than those of the group without GDM(P<0.05).Although the TC and LDL of the pregnant women in the macrosomia GDM group were slightly higher,HDL was slightly lower than the group without GDM,the difference was not statistically significant(P>0.05).7.Analysis of the correlation between the blood lipid levels of pregnant women with GDM in the third trimester and the weight of their newborns:A total of 67 GDM pregnant women were included in the macrosomia group and the control group,and the correlation between their blood lipid levels in the third trimester of pregnancy and the weight of the newborns were analyzed,the results show that TG levels in the third trimester of pregnancy were positively correlated with the weight of newborns in GDM pregnant women(r=0.608,P<0.05).There was no significant correlation between TC,HDL and LDL in the third trimester(p>0.05).Conclusion:1.GWG,gestational week of delivery,and high TG in the third trimester are all independent risk factors for the delivery of macrosomia.HDL levels in the third trimester are negatively correlated with the risk of macrosomia.Combined with the above independent risk factors of pregnant women and the HDL level in the third trimester of pregnancy,comprehensive consideration has good predictive value for the delivery of macrosomia.2.Pregnant women with macrosomia are more likely to have GDM during pregnancy.The level of TG in late pregnancy is positively correlated with the weight of newborns in GDM pregnant women.3.Strengthening nutritional management during pregnancy,controlling the excessive weight gain of pregnant women,monitoring and regulating blood lipid levels during pregnancy,choosing appropriate delivery methods to terminate pregnancy in a timely manner will help reduce the incidence of macrosomia,reduce adverse pregnancy outcomes,and ensure the safety of mothers and babies.