Analysis of the impact of hypertriglyceridemia in the second trimester of pregnancy on adverse maternal and neonatal outcomes in elderly pregnant women

Guo Nan; Chen Yun; Zhang Pei; Wu Yang; Zhang Xin; Dai Dongxia; Zhou Xin

doi:10.11986/j.issn.1673-873X.2024.07.18

Abstract：Objective To explore the relationship between hypertriglyceridemia(HTG)in the second trimester of pregnancy in elderly pregnant women and adverse maternal and neonatal outcomes,aiming to provide a reference for perinatal care.Methods A total of 1 690 pregnant women who delivered at a tertiary hospital in Jiangsu from October 2021 to March 2022 were selected as the study participants.Sociodemographic data,clinical data of pregnancy,and perinatal outcomes were col-lected.The study participants were allocated to an elderly group(≥35 years old)and a non-elderly group(＜35 years old)based on age,and their blood lipid levels in the second trimester[serum total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C)]were measured.The study par-ticipants were further allocated to the elderly HTG group,elderly non-HTG group,non-elderly HTG group,and non-elder-ly non-HTG group based on TG levels.The adverse maternal and neonatal outcomes of different groups were compared.Re-sults There were statistically significant differences in age,pregnancy number,delivery number,pre-pregnancy body mass index(BMI),and delivery gestational week between the elderly and non-elderly groups(P＜0.05).In terms of blood lipid levels,a statistically significant difference was noted in TG levels between the two groups(P＜0.05).The incidence of hy-pertensive disorders of pregnancy,cesarean section rate,preterm birth rate,gestational diabetes mellitus(GDM)incidence,and the incidence of delivering a large-for-gestational-age(LGA)infant were all statistically significant(P＜0.05).The eld-erly HTG group had the highest incidence of GDM,which was statistically significant compared to the non-elderly groups(P＜0.008),and the non-elderly non-HTG group had a lower GDM incidence than the non-elderly HTG group(P＜0.008).Within the elderly group,the incidence of delivering an LGA infant was statistically significant(P＜0.008),as was the comparison within the non-elderly group(P＜0.008),with both showing higher incidences in the HTG groups.No sta-tistically significant differences were observed in thyroid disease,postpartum hemorrhage,and the incidence of small-for-gestational-age infants and neonatal asphyxia among the four groups(P＞0.05).Logistic regression analysis showed that pre-pregnancy BMI(OR=1.104,95％CI:1.060-1.150),weight gain during pregnancy(OR=0.925,95％CI:0.901-0.950),and second-tri-mester TG levels(OR=1.244,95％CI:1.045-1.483)were influencing factors for GDM;pre-pregnancy BMI(OR=1.225,95％CI:1.164-1.289),weight gain during pregnancy(OR=1.085,95％CI:1.051-1.119),and second-trimester TG levels(OR=1.292,95％CI:1.040-1.606)were influencing factors for the occurrence of LGA infants.Conclusion Elderly preg-nant women are prone to HTG,and high TG levels are associated with adverse pregnancy outcomes such as GDM and LGA infants.Therefore,it is advocated that women become pregnant at an appropriate age,control their weight before pregnan-cy,and pay attention to blood lipid levels during pregnancy.Clinically,there should be increased monitoring and manage-ment of pregnant women's TG levels.