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. 2022 Aug 1;51(4):462-469.
doi: 10.3724/zdxbyxb-2022-0144.

Relationship between changes of high-density lipoprotein cholesterol levels in advanced pregnancy and the risk of neonatal small for gestational age in healthy full-term puerpera

Jing Wang, Menglin Zhou, Danqing Chen

Relationship between changes of high-density lipoprotein cholesterol levels in advanced pregnancy and the risk of neonatal small for gestational age in healthy full-term puerpera

Jing Wang et al. Zhejiang Da Xue Xue Bao Yi Xue Ban. .

Abstract

Objective: To explore the relationship between changes in blood high-density lipoprotein cholesterol (HDL-C) levels in advanced pregnancy and the risk of small for gestational age (SGA) in healthy full-term pregnant women.

Methods: In this retrospective nested case-control study, pregnant women who got antenatal visits and experienced a healthy full-term delivery in Affiliated Women's Hospital, Zhejiang University School of Medicine in 2017 were enrolled. From the cohort, 249 women delivered SGA infants with completed clinical data were set as SGA group, 996 women who delivered normal neonates were randomly selected as matched controls (1∶4). The data of baseline characteristics, the HDL-C levels in 24 th-27 th week and after 37 th week were collected, the average HDL-C changes every four weeks in the third trimester (ΔHDL-C) were calculated. Paired t test was used to compare the differences of HDL-C and ΔHDL-C between cases and controls, and a conditional logistic regression model was applied to analyze the association between ΔHDL-C and the risk of SGA.

Results: HDL-C levels after the 37 th week in both groups were lower than those in mid-pregnancy (ΔHDL-C<0 and P<0.05 for both groups), while the ΔHDL-C levels in SGA group were significantly higher ( P<0.05). Compared with women with low ΔHDL-C, the risk of SGA was higher for women with middle and high ΔHDL-C ( OR=1.74, 95% CI：1.22-2.50; OR=2.48, 95% CI：1.65-3.70, both P<0.05).

Conclusion: In healthy full-term pregnant women, the risk of SGA is associated with the HDL-C changing trend, HDL-C level decreasing slowly or even raising in the third trimester indicate that SGA may be likely to occur.

Keywords: Advanced pregnancy; Full-term pregnancy; High-density lipoprotein-cholesterol; Nested case-control study; Retrospective study; Small for gestational age.

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Conflict of interest statement

所有作者均声明不存在利益冲突

Figures

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图1
研究对象筛选过程及匹配条件 HDL-C：高密度脂蛋白胆固醇；SGA：小于胎龄儿.
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图2
基于对照组五分位数的ΔHDL-C与发生小于胎龄儿的剂量-反应关系 黑色圆点表示五分位数的各区间相对于参考区间的比值比. ΔHDL-C：孕晚期平均每4周HDL-C水平的变化. HDL-C：高密度脂蛋白胆固醇.
See this image and copyright information in PMC

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