背景:先前的动物模型研究强调了胆固醇及其氧化衍生物(氧固醇)在子宫收缩活动中的作用,然而,与高胆固醇血症相关的脂毒性状态可能导致难产。因此,在人类妊娠队列中,我们调查了孕妇妊娠中期胆固醇和氧固醇浓度是否与分娩时间相关.
方法:我们对健康孕妇(N=25)的血清样本和出生结局数据进行了二次分析,并在妊娠22-28周时收集了中期空腹血清样本。分析血清总C,HDL-C,和LDL-C通过直接自动酶法和氧化固醇谱,包括7α-羟基胆固醇(7αOHC),7β-羟基胆固醇(7βOHC),24-羟基胆固醇(24OHC),25-羟基胆固醇(25OHC),27-羟基胆固醇(27OHC),和7-酮胆固醇(7KC)通过液相色谱-选择离子监测-稳定同位素稀释-大气压化学电离-质谱。使用多变量线性回归对产妇无效率和年龄进行调整,评估了产妇孕中期血脂与产程(分钟)之间的关联。
结果:血清24OHC每增加1个单位,观察到分娩时间增加(0.96分钟[0.36,1.56],p<0.01),25OHC(7.02分钟[1.92,12.24],p=0.01),27OHC(0.54min[0.06,1.08],p<0.05),7KC(8.04分钟[2.7,13.5],p<0.01),和总氧固醇(0.42分钟[0.18,0.06],p<0.01]。产程与血清总C无显著关联,LDL-C,或HDL-C被观察到。
结论:在这个队列中,妊娠中期母体氧固醇浓度(24OHC,25OHC,27OHC,和7KC)与产程时间呈正相关。鉴于人口少和使用自我报告的劳动时间,后续研究需要确认。
BACKGROUND: Previous animal model studies have highlighted a role for cholesterol and its oxidized derivatives (oxysterols) in uterine contractile activity, however, a lipotoxic state associated with hypercholesterolemia may contribute to labor dystocia. Therefore, we investigated if maternal mid-pregnancy cholesterol and oxysterol concentrations were associated with labor duration in a human pregnancy cohort.
METHODS: We conducted a secondary analysis of serum samples and birth outcome data from healthy pregnant women (N = 25) with mid-pregnancy fasting serum samples collected at 22-28 weeks of gestation. Serum was analyzed for total-C, HDL-C, and LDL-C by direct automated enzymatic assay and oxysterol profile including 7α-hydroxycholesterol (7αOHC), 7β-hydroxycholesterol (7βOHC), 24-hydroxycholesterol (24OHC), 25-hydroxycholesterol (25OHC), 27-hydroxycholesterol (27OHC), and 7-ketocholesterol (7KC) by liquid chromatography-selected ion monitoring-stable isotope dilution-atmospheric pressure chemical ionization-mass spectroscopy. Associations between maternal second trimester lipids and labor duration (minutes) were assessed using multivariable linear regression adjusting for maternal nulliparity and age.
RESULTS: An increase in labor duration was observed for every 1-unit increment in serum 24OHC (0.96 min [0.36,1.56], p < 0.01), 25OHC (7.02 min [1.92,12.24], p = 0.01), 27OHC (0.54 min [0.06, 1.08], p < 0.05), 7KC (8.04 min [2.7,13.5], p < 0.01), and total oxysterols (0.42 min [0.18,0.06], p < 0.01]. No significant associations between labor duration and serum total-C, LDL-C, or HDL-C were observed.
CONCLUSIONS: In this cohort, mid-pregnancy concentrations of maternal oxysterols (24OHC, 25OHC, 27OHC, and 7KC) were positively associated with labor duration. Given the small population and use of self-reported labor duration, subsequent studies are required for confirmation.