Maternal lipids at mid-pregnancy and the risk of preterm delivery.
Maternal lipids at mid-pregnancy and the risk of preterm delivery.
复制标题
DOI：
10.1111/j.1600-0412.2012.01391.x
复制
发表时间：
2012-06
影响因子：
4.3
通讯作者：
Evans RW
中科院分区：
文献类型：
--
作者：
Mudd LM;Holzman CB;Catov JM;Senagore PK;Evans RW
本研究调查了妊娠中期母体血脂水平与医学指征或自发性早产之间的关系。前瞻性队列研究。从美国密歇根州五个社区的52个诊所招募了妇女（1998-2004年）。妊娠15-27周的孕妇入组，并随访至分娩（n=3019）。在研究入组时采集一份血液样本。血脂，即，在一个子队列（n= 1，309）中测量总胆固醇（TC）、高密度脂蛋白（HDLc）、低密度脂蛋白（LDLc）胆固醇和甘油三酯（TG）。有221例自发分娩，100例医学指征早产和988例足月分娩。多分类逻辑回归模型检查了胆固醇水平（低：<10 th %tile，参考：10 th-<70 th %tile，高：≥ 70 th %tile）、TG四分位数（参考：第一四分位数）和分娩结局（参考：足月）之间的关系。低TC（校正比值比（aOR）= 2.04，95%可信区间（CI）：1.12，3.72）、低HDLc（aOR=1.89，95%CI：1.04，3.42）或低LDLc（aOR =1.96，95%CI：1.09，3.54）的女性中，医学指征性早产的几率增加。高TC（aOR=1.51，95%CI：1.06，2.15）、高LDLc（aOR=1.42，95%CI：0.99，2.04）或高TG（第三和第四四个四分位数分别为aOR=1.90，95%CI：1.21，2.97和aOR=1.72，95%CI：1.06，2.78）的妇女中自发性早产的几率增加。极低的TC、HDLc和LDLc与医学指征性早产的风险适度增加相关，而高TC、LDLc和TG适度增加自发性早产的风险。需要进一步的研究来揭示这些关联的解释，并确定母体脂质的最佳范围。
This study examined associations between maternal lipid levels at mid-pregnancy and preterm delivery, medically indicated or spontaneous. Prospective cohort study. Women were recruited from 52 clinics in five Michigan, U.S.A communities (1998–2004). Pregnant women were enrolled at 15–27 weeks’ gestation and followed to delivery (n=3019). A single blood sample was obtained at study enrollment. Blood lipids, i.e., total (TC), high-density lipoprotein (HDLc), low-density lipoprotein (LDLc) cholesterol, and triglycerides (TG), were measured on a subcohort (n=1,309). There were 221 spontaneous, 100 medically indicated preterm deliveries and 988 term deliveries. Polytomous logistic regression models examined relations among cholesterol levels (Low: <10th %tile, Referent: 10th–<70th %tile, High: ≥70th %tile), quartiles of TG (Referent: first quartile) and delivery outcome (Referent: term). Odds of medically indicated preterm delivery were increased among women with low TC (adjusted odds ratio (aOR)= 2.04, 95% confidence interval (CI): 1.12,3.72), low HDLc (aOR=1.89, 95%CI: 1.04,3.42), or low LDLc (aOR=1.96, 95%CI: 1.09,3.54). Odds of spontaneous preterm delivery were increased among women with high TC (aOR=1.51, 95%CI: 1.06,2.15), high LDLc (aOR=1.42, 95%CI: 0.99,2.04) or high TG (aOR=1.90, 95%CI: 1.21,2.97 and aOR=1.72, 95%CI: 1.06,2.78 for third and fourth quartiles, respectively). Extremely low TC, HDLc and LDLc were associated with a modest increase in risk of medically indicated preterm delivery, while high TC, LDLc and TG modestly increased risk of spontaneous preterm delivery. Further research is needed to uncover explanations for these associations and to identify optimal ranges for maternal lipids.