孕早期血脂水平与妊娠期高血压的关系研究

目的 探讨孕早期血脂水平与妊娠期高血压(GH)发生风险的关系.方法 对自2013年1月至2013年4月在北京妇产医院进行常规产前检查并在本院分娩的1 906例孕妇进行前瞻性巢式病例对照研究,病例组为发生妊娠期高血压的孕妇,对照组为血压正常的孕妇.收集年龄、身高、孕前体重、高血压家族史、孕次、产次以及首次产检检测空腹血脂的孕周和实验室结果等资料,统计学方法采用t检验、χ2检验及多因素logistic回归分析.结果 病例组的孕早期三酰甘油(TG)水平(1.37±0.57mmol/L)高于对照组(1.22±0.59mmol/L),t=2.65, P=0.01.控制混杂因素后,TG每增加1mmol/L发生GH的风险增加34%(95%可信区间为1.01~1.78,P<0.05);孕前超重/肥胖孕妇发生GH的风险是孕前体重正常孕妇的2.85倍(95%可信区间为1.62~5.03,P<0.01);孕次≤2次的孕妇发生GH的风险是孕次>2次孕妇的2.45倍(95%可信区间为1.19~5.06,P<0.05).结论 孕早期的TG水平,独立于孕前BMI,是GH的显著危险因素.

Correlation of fasting lipid level in early pregnancy with gestational hypertension

Objective To evaluate the association of fasting lipid level in early pregnancy and the risk of gestational hypertension (GH).Methods A prospective nest case-control study was conducted on 1 906 pregnant women enrolled from January to April in 2013, who received routine examination and gave birth in Beijing Obstetrics and Gynecology Hospital.Case group included the patients with GH, while control group included patients with normal blood pressure.Age, height, weight before pregnancy, family history of hypertension, gravidity, parity, gestational week when fasting serum lipid tested at first prenatal examination, and laboratory data were collected and analyzed with t test, chi-square test and multiple Logistic regression analysis.Results Triglyceride (TG) level in early pregnancy in the case group was 1.370.57 mmol/L, which was higher than that in the control group (1.220.59 mmol/L) (t=2.65, P=0.01).After adjusting all confounding factors, the risk of GH increased by 34% when TG increasing 1mmol/L (95%CI: 1.01-1.78, P<0.05).The risk of GH among overweight and obese women before pregnancy was 2.85 times of that among women with normal weight (95%CI:1.62-5.03, P<0.01).The risk of GH among women with gravidity ≤2 was 2.45 times of that among women with gravidity >2 (95%CI: 1.19-5.06, P<0.05).Conclusion TG level in early pregnancy is independent of pre-pregnancy BMI, and it is a notable risk factor of GH.