| Objective:To seek for an appropriate reference range of maternal blood lipid in Chifeng district,and probe into the effect of maternal blood lipid on pregnant outcome,so as to afford experience and basis for clinical monitoring and intervention,and ultimately reduce maternal and fetal complications and ensure the safety of mother and infant.Methods:The patients who delivered in the obstetrics department of Chifeng University Affiliated Hospital from November 2020 to December 2022 fully met the requirements of this study,including 400 cases of the first trimester,200 cases of the second trimester and 300 cases of the third trimester.According to the principle of age-balanced enrollment,300 cases of non-pregnant group in the same term were collected.The rudimental information,serum lipid status and maternal and infant outcomes of gestational group were gathered,and the basic information and blood lipid status of non-pregnant control group were also collected.Kolmogorov Smirnov test was applied to checkout the normality of all types of data.Compare age,nationality and serum lipid discrepancy between different periods of pregnancy and non-pregnancy by using Kruskar-Wallis H test.The percentile method and normal distribution method were used to set up the reference range of blood lipids during pregnancy in Chifeng area.According to the established reference range,the pregnant group was divided into two groups:normal blood lipid group and dyslipidemia group,and the influence of blood lipid on maternal and infant outcomes were analyzed:Chi-square test,Fisher’s exact test or Mann-Whitney U test was used to compare the differences of maternal and infant outcomes between the two groups.And moreover the correlation between blood lipid level and birth weight and blood loss was analyzed by using Spearman test,with P<0.05 being statistically significant.Results:1、The reference range established according to the method of the National Cholesterol Program of the United States didn’t meet the requirements,however which established according to the method provided by the C28-A2 document of the American Committee for Clinical Laboratory Standardization met the requirements.Finally,the reference range of blood lipid in the pregnant group was determined:first trimester:TG 0.56-3.20mmol/L;TC 2.73-5.56mmol/L;HDL>1.04mmol/L;LDL<3.30mmol/L;second trimester:TG 0.82-3.83mmol/L;TC3.01-6.69mmol/L;HDL>1.15mmol/L;LDL<4.00mmol/L;third trimester:TG 1.52-7.09mmol/L;TC4.02-8.57mmol/L;HDL>1.22mmol/L;LDL<5.16mmol/L.Reference range of blood lipid in the non-pregnant control group:TG 0.43-2.19mmol/L;TC 2.73-5.34mmol/L;HDL>0.86mmol/L;LDL<3.65mmol/L.2、Differences in blood lipid between pregnant group and non-pregnant control group:There was no significant discrepancy between TC in first trimester and non-pregnancy,HDL in second trimester and third trimester,(P>0.05);The differences of TG,TC,HDL and LDL in other periods were statistically significant(P<0.05).The level of maternal blood lipid during pregnancy were generally higher than that during non-pregnancy,and in the mass,the level of third trimester>the level of second trimester>the level of first trimester.3、Effect of pregnancy serum lipids on maternal and infant outcomes:The difference between dyslipidemia group and normal blood lipid group was statistically significant only in the incidence of GDM(P<0.001).The proportion of gestational diabetes mellitus in dyslipidemia and normal pregnant women were 25.92%and 13.98%respectively,and the risk ratio of maternal dyslipidemia to gestational diabetes mellitus was OR=2.177(95%confidence interval=1.408-3.368).There was no significant discrepancy in the incidence of hypertensive disorders in pregnancy,intrahepatic cholestasis of pregnancy,premature delivery and delivery mode between the dyslipidemia group and normal blood lipid group(P>0.05).Cause there lacked of the data of acute pancreatitis and thrombotic diseases,it was impossible to analyze them.In addition,there was no significant discrepancy between birth weight and blood loss during pregnancy between the normal and dyslipidemia groups(P>0.05).However,when analyzing the correlation between blood lipid,birth weight and the amount of bleeding during delivery,it was found that maternal TG(P<0.001,r_s=0.223)level of the third trimester was weakly positively correlated with neonatal birth weight,while maternal TC(P<0.05,r_s=-0.116)level of the first trimester,LDL(P<0.05,r_s=-0.115)level of the first trimester,TC(P<0.05,r_s=-0.160)level of the second trimester and LDL(P<0.05,r_s=-0.115)level of the third trimester were weakly negatively correlated with neonatal birth weight,and maternal blood lipid was not significantly correlated with blood loss during delivery.Conclusions:The approximate reference range of blood lipid during pregnancy in Chifeng area: early pregnancy:TG 0.56-3.20mmol/L;TC 2.73-5.56mmol/L;HDL>1.04mmol/L;LDL<3.30mmol/L;second trimester:TG 0.82-3.83mmol/L;TC3.01-6.69mmol/L;HDL>1.15mmol/L;LDL<4.00mmol/L;late trimester:TG 1.52-7.09mmol/L;TC4.02-8.57mmol/L;HDL>1.22mmol/L;LDL<5.16mmol/L;The approximate reference range of blood lipid for non-pregnant healthy women in Chifeng area:TG 0.43-2.19mmol/L;TC 2.73-5.34mmol/L;HDL>0.86mmol/L;LDL<3.65mmol/L.The incidence of dyslipidemia in pregnant women in Chifeng area was 15.00%.The current domestic guidelines for dyslipidemia for adults in 2016 edition and the recommended scope of Williams obstetrics were not applicable to the judgment of dyslipidemia in pregnant women in Chifeng area.In addition,this study also found that dyslipidemia can increase the risk of gestational diabetes mellitus.At the same time,maternal blood lipid level during pregnancy may be related to neonatal birth weight,which may become a predictor of neonatal birth weight in the future. |
PDF Full Text Request