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目的探讨孕早期谷丙转氨酶(ALT)水平与发生巨大儿或大于胎龄儿(LGA)的相关性。方法利用天津市妇幼卫生信息系统记录的2009—2010年天津市内6区和滨海新区孕早期接受第一次产检的26 956名单胎妊娠孕妇的孕期基本信息、检查结果和分娩信息,通过logistic回归分析孕早期ALT水平与巨大儿或LGA发生的关联。结果 26 956名孕妇孕早期ALT中位数水平为15.2 U/L(四分位数界值:11.0~22.0 U/L),ALT≥40 U/L占5.1%。分娩巨大儿者占10.1%,LGA占17.7%。多因素logistic回归结果显示,相对于ALT水平<40 U/L,ALT水平≥40 U/L组孕妇更容易分娩出巨大儿(OR=1.192,95%CI=1.008~1.410)和LGA(OR=1.160,95%CI=1.012~1.330)。以ALT<40 U/L且非肥胖为参考组,ALT<40 U/L且肥胖(OR=3.011,95%CI=2.593~3.496)、ALT≥40 U/L且非肥胖(OR=1.320,95%CI=1.097~1.589)、ALT≥40 U/L且肥胖(OR=3.837,95%CI=2.675~5.502)均与巨大儿发生有关联。同样,ALT<40 U/L且肥胖(OR=2.781,95%CI=2.458~3.147)、ALT≥40 U/L且非肥胖(OR=1.238,95%CI=1.066~1.437)、ALT≥40 U/L且肥胖(OR=3.766,95%CI=2.757~5.144)均与LGA发生有关联。结论孕早期ALT水平单独或联合母亲肥胖均与巨大儿或LGA的发生相关。
Objective To investigate the correlation between the level of ALT and the occurrence of giant or larger than gestational age (LGA) in early pregnancy. Methods The basic information, test results and delivery information of 26,956 pregnant women with singleton pregnancies in the 6 districts of Tianjin and Binhai New Area during the first trimester of pregnancy from 2009 to 2010 recorded by Tianjin MCH system were analyzed by logistic regression Analysis of early pregnancy ALT levels associated with macrosomia or LGA. Results The median level of ALT in 26 956 pregnant women during the first trimester was 15.2 U / L (interquartile range: 11.0-22.0 U / L), and ALT≥40 U / L accounted for 5.1%. 10.1% of children with huge delivery, LGA accounted for 17.7%. Multivariate logistic regression analysis showed that males with ALT levels> 40 U / L were more likely to give birth to giant children (OR = 1.192, 95% CI = 1.008-1.410) and LGA (OR = 1.160, 95% CI = 1.012-1.330). ALT <40 U / L and obese (OR = 3.011, 95% CI = 2.593-3.496), ALT> 40 U / L and non-obese (OR = 1.320, 95% CI = 1.097-1.589), ALT≥40 U / L and obesity (OR = 3.837, 95% CI = 2.675-5.502) were all associated with macrosomia. Similarly, ALT <40 U / L was obese (OR = 2.781, 95% CI = 2.458-3.147), ALT≥40 U / L and was not obese (OR = 1.238, 95% CI = 1.066-1.437) U / L and obesity (OR = 3.766,95% CI = 2.757-5.144) were associated with the occurrence of LGA. CONCLUSIONS: ALT levels in early pregnancy alone or in combination with maternal obesity are associated with the occurrence of macrosomia or LGA.