Analysis of Macrosomia Risk between Pregnancy Weight Gain and Glycolipid Metabolism among Normal Pregnant Women

doi:10.12280/gjfckx.20230346

Abstract

Abstract:

Objective: To analyze the pregnancy weight gain and glycolipid levels during pregnancy in normal pregnant women who delivered macrosomia without pregnancy complications, obesity, and advanced age, and explore their influence on the risk of macrosomia. Methods: Normal pregnant women who underwent regular prenatal examination were selected as the research object in the International Peace Maternal and Child Health Hospital from September 2020 to December 2020, and divided into macrosomia group (104 cases) and normal control group (258 cases) according to neonatal weight. The difference of basic situation and the levels of glucose and lipid metabolism were compared, and Logistic regression models were adopted to explore the risk factors of macrosomia in normal pregnant women. Results: Compared with the normal control group, the macrosomia group had higher levels of fasting blood glucose, triglyceride (TG) and lower levels of high density lipoprotein (HDL) at all stages of pregnancy (P<0.05), there are lager difference of TG level and smaller difference of HDL level in macrosomia group (both P<0.05). Compared with those who gained proper weight during pregnancy, those who gained too much weight had 142% increased risk of delivery of macrosomia (OR=2.42, 95%CI: 1.34-4.39) and those who had adequate weight gain had 73% decreased risk of delivery of macrosomia (OR=0.27, 95%CI: 0.10-0.77). For every 1 mmol/L increase in HDL in late pregnancy, the risk of delivery of macrosomia decreased by 79% (OR=0.21, 95%CI: 0.08-0.57). Conclusions: Normal pregnant women should control their weight gain strictly during pregnancy to reduce the risk of macrosomia, and lipid metabolism needs to be paid attention to, in which the level and change of HDL in late pregnancy may assist in the screening of cryptogenic macrosomia.

Key words: Fetal macrosomia, Pregnancy, Blood glucose, Lipids, Gestational weight gain

GAO Jing, QIN Fei, CHEN Chao, XIONG Yao-xi, CHENG Wei-wei. Analysis of Macrosomia Risk between Pregnancy Weight Gain and Glycolipid Metabolism among Normal Pregnant Women[J]. Journal of International Obstetrics and Gynecology, 2024, 51(2): 176-180.

Figures/Tables 5

References 21

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组别	n	年龄（岁）		妊娠前BMI （kg/m²）			妊娠期增重（kg）		分娩孕周（周）			新生儿出生体质量（g）		男胎			FPG（mmol/L）
组别	n	年龄（岁）		妊娠前BMI （kg/m²）			妊娠期增重（kg）		分娩孕周（周）			新生儿出生体质量（g）		男胎			妊娠早期	妊娠中期		妊娠晚期
巨大儿组	104	29.7±2.9		21.4±2.1			17.1±4.2		39.8±0.8			4 171.4±175.9		75（72.1）			4.7±0.4	4.2±0.4		4.5±0.5
对照组	258	29.4±2.6		20.6±1.6			14.2±4.4		39.4±1.0			3 236.7±307.2		114（44.2）			4.6±0.4	4.0±0.3		4.4±0.5
t或χ²或H		1.049		4.107			5.722		3.946			29.149		23.173			2.173	5.033		2.285
P		0.294		<0.001			<0.001		<0.001			<0.001		<0.001			0.031	<0.001		0.023
组别	妊娠早期血脂（mmol/L）							妊娠晚期血脂（mmol/L）							妊娠期血脂变化（mmol/L）
组别	TC		TG		HDL	LDL		TC		TG	HDL		LDL		△TC	△TG			△HDL		△LDL
巨大儿组	4.4±0.6		1.4±0.7		1.8±0.4	2.3±0.6		6.3±1.1		3.1±1.3	1.9±0.4		3.7±1.1		1.8±0.9	1.6（1.1，2.2）			0.1±0.3		1.4±1.0
对照组	4.4±0.8		1.2±0.5		2.0±0.3	2.3±0.6		6.5±1.0		2.7±0.9	2.2±0.4		3.7±1.0		2.0±0.8	1.4（0.9，1.8）			0.2±0.3		1.5±0.7
t或χ²或H	0.100		2.447		3.652	0.728		1.520		3.276	5.857		0.316		2.409	7.713			3.256		0.985
P	0.906		0.015		<0.001	0.469		0.130		0.001	<0.001		0.757		0.064	0.006			0.001		0.326

组别	n	年龄（岁）		妊娠前BMI （kg/m²）			妊娠期增重（kg）		分娩孕周（周）			新生儿出生体质量（g）		男胎			FPG（mmol/L）
组别	n	年龄（岁）		妊娠前BMI （kg/m²）			妊娠期增重（kg）		分娩孕周（周）			新生儿出生体质量（g）		男胎			妊娠早期	妊娠中期		妊娠晚期
巨大儿组	104	29.7±2.9		21.4±2.1			17.1±4.2		39.8±0.8			4 171.4±175.9		75（72.1）			4.7±0.4	4.2±0.4		4.5±0.5
对照组	258	29.4±2.6		20.6±1.6			14.2±4.4		39.4±1.0			3 236.7±307.2		114（44.2）			4.6±0.4	4.0±0.3		4.4±0.5
t或χ²或H		1.049		4.107			5.722		3.946			29.149		23.173			2.173	5.033		2.285
P		0.294		<0.001			<0.001		<0.001			<0.001		<0.001			0.031	<0.001		0.023
组别	妊娠早期血脂（mmol/L）							妊娠晚期血脂（mmol/L）							妊娠期血脂变化（mmol/L）
组别	TC		TG		HDL	LDL		TC		TG	HDL		LDL		△TC	△TG			△HDL		△LDL
巨大儿组	4.4±0.6		1.4±0.7		1.8±0.4	2.3±0.6		6.3±1.1		3.1±1.3	1.9±0.4		3.7±1.1		1.8±0.9	1.6（1.1，2.2）			0.1±0.3		1.4±1.0
对照组	4.4±0.8		1.2±0.5		2.0±0.3	2.3±0.6		6.5±1.0		2.7±0.9	2.2±0.4		3.7±1.0		2.0±0.8	1.4（0.9，1.8）			0.2±0.3		1.5±0.7
t或χ²或H	0.100		2.447		3.652	0.728		1.520		3.276	5.857		0.316		2.409	7.713			3.256		0.985
P	0.906		0.015		<0.001	0.469		0.130		0.001	<0.001		0.757		0.064	0.006			0.001		0.326

组别	n	FPG（mmol/L）			妊娠早期血脂（mmol/L）				妊娠晚期血脂（mmol/L）				妊娠期血脂变化（mmol/L）
组别	n	妊娠早期	妊娠中期	妊娠晚期	TC	TG	HDL	LDL	TC	TG	HDL	LDL	△TC	△TG	△HDL	△LDL
巨大儿组	8	4.7±0.3	4.4±0.4	4.4±0.4	4.7±0.7	1.5±0.7	1.9±0.3	2.5±0.5	6.6±1.0	3.2±1.1	2.0±0.4	3.9±0.6	1.8±0.6	1.7±0.7	0.0±0.1	1.3±0.6
对照组	59	4.7±0.4	3.9±0.4	4.3±0.4	4.5±0.6	1.2±0.4	2.0±0.3	2.3±0.5	6.6±1.0	2.6±0.8	2.2±0.4	3.8±1.0	2.1±0.8	1.3±0.6	0.3±0.3	1.5±0.7
t		0.245	2.893	0.663	0.819	1.418	0.707	0.883	0.010	1.718	1.814	0.120	0.794	1.709	2.254	0.600
P		0.807	0.015	0.512	0.416	0.161	0.484	0.382	0.992	0.091	0.075	0.905	0.430	0.093	0.028	0.552

组别	n	FPG（mmol/L）			妊娠早期血脂（mmol/L）				妊娠晚期血脂（mmol/L）				妊娠期血脂变化（mmol/L）
组别	n	妊娠早期	妊娠中期	妊娠晚期	TC	TG	HDL	LDL	TC	TG	HDL	LDL	△TC	△TG	△HDL	△LDL
巨大儿组	8	4.7±0.3	4.4±0.4	4.4±0.4	4.7±0.7	1.5±0.7	1.9±0.3	2.5±0.5	6.6±1.0	3.2±1.1	2.0±0.4	3.9±0.6	1.8±0.6	1.7±0.7	0.0±0.1	1.3±0.6
对照组	59	4.7±0.4	3.9±0.4	4.3±0.4	4.5±0.6	1.2±0.4	2.0±0.3	2.3±0.5	6.6±1.0	2.6±0.8	2.2±0.4	3.8±1.0	2.1±0.8	1.3±0.6	0.3±0.3	1.5±0.7
t		0.245	2.893	0.663	0.819	1.418	0.707	0.883	0.010	1.718	1.814	0.120	0.794	1.709	2.254	0.600
P		0.807	0.015	0.512	0.416	0.161	0.484	0.382	0.992	0.091	0.075	0.905	0.430	0.093	0.028	0.552

组别	n	FPG（mmol/L）			妊娠早期血脂（mmol/L）				妊娠晚期血脂（mmol/L）				妊娠期血脂变化（mmol/L）
组别	n	妊娠早期	妊娠中期	妊娠晚期	TC	TG	HDL	LDL	TC	TG	HDL	LDL	△TC	△TG	△HDL	△LDL
巨大儿组	36	4.7±0.5	4.1±0.4	4.4±0.7	4.6±0.7	1.4±0.6	1.9±0.4	2.5±0.6	6.5±1.2	2.9±0.8	2.0±0.4	3.9±1.0	1.9±0.9	1.5（1.2，2.1）	0.1±0.3	1.5±0.9
对照组	117	4.6±0.3	4.0±0.3	4.4±0.4	4.4±0.8	1.2±0.5	2.0±0.4	2.3±0.6	6.5±1.0	2.7±1.0	2.2±0.4	3.8±1.0	2.0±0.7	1.3（0.9，1.8）	0.2±0.3	1.5±0.7
t或H		1.523	2.076	0.624	1.054	1.175	1.947	1.497	0.060	1.095	2.914	0.632	0.995	1.856	1.187	0.436
P		0.130	0.061	0.531	0.294	0.242	0.054	0.137	0.952	0.276	0.004	0.527	0.320	0.609	0.238	0.664