Prepregnancy Lipids Related to Preterm Birth Risk: The Coronary Artery Risk Development in Young Adults Study
Prepregnancy Lipids Related to Preterm Birth Risk: The Coronary Artery Risk Development in Young Adults Study
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DOI：
10.1210/jc.2009-2028
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发表时间：
2010-08-01
影响因子：
5.8
通讯作者：
Gunderson, Erica P.
中科院分区：
文献类型：
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作者：
Catov, Janet M.;Ness, Roberta B.;Gunderson, Erica P.
背景：早产与母体心血管风险相关，但机制尚不清楚。目的：我们认为血脂异常可能使妇女易患这两种疾病，而且孕前血脂可能与早产风险有关。我们假设低或高的孕前血浆脂质与早产有关。设计、环境和参与者：共有1010名女性（49%为黑人）参加了多中心前瞻性年轻成人冠状动脉风险发展研究，在20年的随访期间至少有一次单胎分娩。主要结局指标：基线后早产小于34周或34至小于37周vs大于37周妊娠。结果：我们发现孕前胆固醇浓度与早产风险之间呈u型关系。与第二四分位数（195 mg/dl）相比，孕前胆固醇最低四分位数的妇女在正常妊娠的妇女中早产小于34周（优势比3.80；95%可信区间1.07,7.57）。妊娠前甘油三酯、低密度脂蛋白胆固醇或高密度脂蛋白胆固醇与早产之间没有关联。结论：低和高的孕前胆固醇与早产风险有关。这些可能代表了早产的不同结果的不同途径。需要进一步的研究来阐明低胆固醇或高胆固醇与早产和后期后遗症之间的联系机制。[J] .中华内分泌杂志，2000,21(5):377 - 378。
Context: Preterm birth is associated with maternal cardiovascular risk, but mechanisms are unknown.Objective: We considered that dyslipidemia may predispose women to both conditions and that prepregnancy lipids may be related to preterm birth risk. We hypothesized that low or high prepregnancy plasma lipids would be associated with preterm birth.Design, Setting, and Participants: A total of 1010 women (49% black) enrolled in the multicenter, prospective Coronary Artery Risk Development in Young Adults study with at least one singleton birth during 20 yr of follow-up were evaluated.Main Outcome Measure: Postbaseline preterm births less than 34 wk or 34 to less than 37 wk vs. greater than 37 wk gestation.Results: We detected a U-shaped relationship between prepregnancy cholesterol concentrations and preterm birth risk. Women with prepregnancy cholesterol in the lowest quartile compared with the second quartile (195 mg/dl) was also associated with preterm birth less than 34 wk among women with normotensive pregnancies (odds ratio 3.80; 95% confidence interval 1.07, 7.57). There were no associations between prepregnancy triglycerides, low-density lipoprotein cholesterol, or high-density lipoprotein cholesterol and preterm birth.Conclusions: Both low and high prepregnancy cholesterol were related to preterm birth risk. These may represent distinct pathways to the heterogeneous outcome of preterm birth. Additional studies are needed to elucidate mechanisms that link low or high cholesterol to preterm birth and later-life sequelae. (J Clin Endocrinol Metab 95: 3711-3718, 2010)