Maternal serum lipid and uric acid levels at 20 weeks of gestation in predicting preeclampsia, gestational diabetes mellitus and macrosomia
10.3760/cma.j.issn.1007-9408.2012.04.007
- VernacularTitle:妊娠中期母体血脂及尿酸水平对子痫前期、妊娠期糖尿病和巨大儿的预测价值
- Author:
Jianjun ZHOU
;
Yali HU
;
Zhiqun WANG
;
Xia ZHAO
- Publication Type:Journal Article
- Keywords:
Pregnancy;
Triglycerides;
Cholesterol,LDL;
Uric acid;
Pregnancy outcome;
Forecasting
- From:
Chinese Journal of Perinatal Medicine
2012;15(4):217-221
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the values of maternal serum levels of lipid and uric acid at second trimester in predicting preeclampsia,gestational diabetes mellitus and macrosomia. Methods Concentrations of selected metabolic markers including total cholesterol,triglyceride,low density lipoprotein-cholesterol,high density lipoprotein-cholesterol,apolipoprotein AI,apolipoprotein B and uric acid were examined in 1000 healthy singleton primiparous who accepted regular prenatal healthcare in Naniing Drum Tower Hospital,at 20 weeks of gestation from June 2009 to January 2010.All the pregnant women were followed up to their deliveries.Pregnancy complications,such as preeclampsia and gestational diabetes mellitus (GDM),the data of maternal and neonatal outcomes such as gestational age at delivery,neonatal birthweight were recorded.Relationship between adverse outcome and blood lipid,uric acid levels was analyzed by Logistic regression,and the risk factors were confirmed; predictive values of those sensitivity and specificity were calculated by receiver operating characteristic curve. Results Among the 1000 pregnant women, 61 (6.1％) developed preeclampsia and 100 (10.0％) developed GDM.The mean gestational age of delivery was (39.3±1.2) weeks,and the incidence of preterm delivery was 1.5％ (15/1000).The mean birthweight was (3389.6±4 422.8) g,and the prevalence of macrosomia was 8.9％ (89/1000).Women who had elevated triglyceride levels had a 3.42-fold increased risk of preeclampsia (95 ％ CI:1.88-6.22,P =0.000) and 2.12-fold increased risk of GDM (95％ CI:1.38-3.35,P =0.001).Hyperuricemic women experienced a 2.09-fold increased risk of preeclampsia (95％CI:1.24-3.53,P=0.005) and 2.22-fold increased risk of GDM (95％CI:1.32-3.43,P=0.002).Women who had decreased high density lipoprotein-cholesterol level experienced a 2.34-fold increased risk of preeclampsia (95 ％ CI:1.20-4.55,P =0.011),2.03-fold increased risk of GDM (95 ％ CIr:1.33-3.11,P =0.001 ) and 1.67-fold increased risk of macrosomia (95％CI:1.06-2.64,P=0.026).The area under receiver operating characteristic curve of these metabolic markers was 0.56-0.65, the sensitivity was 28％-82％ and the specificity was 34％-85％. Conclusions Hypertriglycemia,hyperuricemia,and hypo high density lipoprotein-cholesterolcmia at 20 weeks of gestation might relate to preeclampsia,GDM and macrosomia,but the predictive values of them are limited.
