Correlation Between Glucose,Lipid Metabolism,Thyroid Function And Pregnancy Outcome In Advanced Age Pregnant Woman

Objective:The global female reproductive age presents a trend of aging.With the implementation of the"universal two-child policy"in China,the proportion of advanced age pregnant women（≥35 years）increases.Because of the characteristic of the advanced age pregnant women metabolism,increase the pregnant women and fetal and neonatal get all kinds of the risk of adverse pregnancy outcomes.This study mainly retrospectively analyzed the glucose,lipid metabolism,thyroid function and pregnancy outcomes of advanced age pregnant women and appropriate age pregnant woman who were enrolled in our hospital from July 1,2017 to June 30,2018.To explore the prevention and treatment of elderly pregnant women during pregnancy complications and adverse pregnancy outcomes.Methods:Retrospective analysis was performed on pregnant women who established pregnancy records in the outpatient department of Korla hospital of the second division of Xinjiang from July 1,2017 to June 30,2018.We use information technology to track the delivery of all pregnant women.After the inclusion criteria and exclusion criteria,819 parturient women were selected to be included in the study,which were divided into group A（20²9years）439 cases,group B（30³4 years）265 cases,and group C（35⁴3 years）115 cases.The results of glucose（GLU）,lipids（TG,TC,HDL-C,LDL-C）and thyroid hormone function（TSH,FT₃,FT₄,TPO-Ab）were collected in all subjects during the early and late pregnancy.The differences of glucose,lipid metabolism and thyroid function were compared among the three groups.The differences of pregnancy complications,pregnancy outcomes and perinatal prognosis were compared among the three groups.The correlation between glucose,lipid,thyroid function and pregnancy complications,pregnancy outcomes and perinatal prognosis was analyzed.Result:Three groups in gestational diabetes,the incidence of pregnancy complicated with hypertension disease,fetal intrauterine growth restriction,macrosomia and cesarean section there is a significant difference（P<0.05）,and the highest rates in the advanced maternal group of pregnant women,pregnancy hypothyroidism,amniotic fluid contamination,premature and newborn asphyxia no statistical difference between the three groups.Risk factors related to GDM:maternal age（OR=2.06,95%CI:1.99-2.12）,glucose in early pregnancy（OR=2.39,95%CI:1.39-4.1）,glucose in late pregnancy（OR=33.25,95%CI:16.25-68.04）,body mass index before pregnancy（OR=1.07,95%CI:1.01-1.15）.Risk factors for macrosomia:Age of pregnant women（OR=1.07,95%CI:1.01-1.15）,days of pregnancy（OR=1.11,95%CI:1.06-1.16）,early pregnancy HDL-C（OR=9.57,95CI:2.16-42.33）,early pregnancy GLU（OR=1.98,95%CI:1.29-3.05）,early pregnancy FT₃(OR=1.51,TG（OR=1.72,95%CI:1.25-2.30）,body mass index before pregnancy（OR=1.09,95%CI:1.01-1.18）,weight gain during pregnancy（OR=1.09,95%CI:1.02-1.17）.Risk factors for hypertension during pregnancy:triglycerides in early pregnancy（OR=1.81,95%CI:1.10-3.00）.Risk factors for fetal intrauterine growth restriction:late pregnancy TSH（OR=3.60,95%CI:1.43-9.05）.Conclusion:The weight gain of pregnant women during pregnancy showed a decreasing trend with age≥35 years.Gestational diabetes mellitus,macrosomia,intrauterine growth and development,and hypertensive disorder complicating pregnancy in the 35-43 age group are much higher than those in the 20-29 age group.HDL-C in early pregnancy was a risk factor for macrosomia,and may be a compensatory increase in lipid metabolism in the body after over-nutrition during pregnancy.The adverse outcomes of gestational diabetes,macrosomia,gestational hypertension,and intrauterine growth restriction in advanced age women are related to age,glucose,and thyroid hormone levels,as well as lipids in early pregnancy and late pregnancy.The indicators are significantly related.