[Relationship between blood lipid levels of pregnant women with glucose metabolism disorders and perinatal outcomes].

OBJECTIVE: To study the relationship between blood lipid levels of pregnant women with glucose metabolism disorders and the perinatal outcomes.

METHODS: Three hundred and fifty-eight pregnant women with glucose metabolism disorders were enrolled in this study, including 28 cases with diabetes mellitus (DM), 152 cases with gestational diabetes mellitus (GDM), 178 cases with gestational impaired glucose tolerance (GIGT). Beckman-CX9 automatic biochemical analyzer was used to measure serum levels of total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C).

RESULTS: (1) The TG, TC, HDL-C and LDL-C levels in GDM group was (2.9 +/- 0.7), (6.7 +/- 1.9), (1.64 +/- 0.31), and (3.7 +/- 0.8) mmol/L, respectively, which were not significantly different from those in GIGT group [TG (2.7 +/- 0.7), TC (6.2 +/- 1.1), HDL-C (1.78 +/- 0.22), and LDL-C (3.8 +/- 0.9) mmol/L, respectively (P > 0.05)]. Maternal serum concentrations of TG and LDL-C were significantly increased in DM group [(3.6 +/- 0.9) and (4.8 +/- 0.6) mmol/L] compared with GIGT group [(2.7 +/- 0.7) and (3.8 +/- 0.9) mmol/L] and GDM group [(2.9 +/- 0.7) and (3.7 +/- 0.8) mmol/L] (P < 0.05). However, the HDL-C (1.24 +/- 0.19) mmol/L in DM group was significantly lower than that in GDM group (1.64 +/- 0.31) mmol/L and GIGT group (1.78 +/- 0.22) mmol/L (P < 0.05). (2) The incidence of pre-eclampsia and preterm labor in the DM group (35.7% and 39.3%) was higher than that in GIGT group (16.8% and 16.8%) and GDM group (14.5% and 19.7%, P < 0.05). Among the three groups, the incidence of polyhydramnios and premature rupture of membrane had no significant difference (P > 0.05). The incidence of fetal distress in the GIGT group (9.8%) was lower than that in DM group (20.2%) and GDM group (21.4%, P < 0.05). The incidence of fetal macrosomia in GDM group (11.2%) and GIGT group (14.4%) was higher than that in DM group (3.5%, P < 0.05).

CONCLUSION: The blood lipid level of pregnant women with glucose metabolism disorders is one of the effective indexes to prognosticate perinatal outcomes. Reducing blood lipid level can decrease the incidence of pre-eclampsia and preterm labor significantly.