Association between maternal blood lipids levels during pregnancy and risk of small-for-gestational-age infants

Abstract

Dyslipidemia in pregnancy are associated with risk of adverse outcomes. As an adverse pregnancy outcome, small-for-gestational-age has been extensively studied in Western countries. However, similar studies have rarely been conducted in Asian countries. Data were derived from 5695 pairs of non-diabetic mothers and neonates between 1 Jan 2014 and 31 Dec 2014. 5.6% neonates in our study were SGA. Serum samples were collected during second and third trimesters for evaluation on fasting lipids levels. The present study intended to explore the associations between maternal lipid profile and small-for-gestational-age neonates. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated and adjusted via logistic regression analysis. After adjustments for confounders, third-trimester total cholesterol levels were associated with a decreased risk for small-for-gestational-age (aOR = 0.622, 95% CI 0.458–0.848, P = 0.002), and third-trimester high-density lipoprotein cholesterol and low-density lipoprotein cholesterol levels were associated with an increased risk for small-for-gestational-age (aOR = 1.955, 95% CI 1.465–2.578, P < 0.001; aOR = 1.403, 95% CI 1.014–1.944, P = 0.041).In the highest gestational weight gain strata, especially the third-trimester, the effect of high-density lipoprotein cholesterol levels on the risk for small-for-gestational-age is larger. High high-density lipoprotein cholesterol level during third trimester could be considered as indicators of a high-risk of small-for-gestational-age, regardless of gestational weight gain.

Association between maternal lipid levels during pregnancy and delivery of small for gestational age: A systematic review and meta-analysis

“…Four of these included publications were cohort studies ( 12 – 14 , 17 ), two were case-control studies ( 15 , 18 ) and two were cross-sectional studies ( 11 , 16 ). They were conducted in different countries, Netherlands ( 12 ), China ( 13 ), Turkey ( 16 ), Japan ( 18 ), Korea ( 14 ), Canada ( 15 ), German ( 17 ) and Egypt ( 11 ) separately. Among the selected studies, three reported maternal lipid profile during early pregnancy ( 12 , 14 , 16 ), three during mid-pregnancy ( 15 , 17 , 18 ), and one during mid and late pregnancy ( 13 ) in detail, yet one study didn’t mention this information ( 11 ).…”

“…It has been well-established that SGA is associated with low pre-pregnancy body mass index (5), sleep disturbances (6), short stature (7), serum plasma protein A levels (8), smoking (9) and maternal antioxidant levels (10). Recently, gestational dyslipidemia has also been reported to be a risk factor for SGA infant delivery (11)(12)(13)(14)(15)(16)(17)(18).…”

“…Preceding reviews have revealed that gestational dyslipidemia is associated with increased incidence of preterm delivery, hypertensive disorders and gestational diabetes mellitus, (26)(27)(28) but epidemiological evidence regarding SGA is conflicting. Some studies showed there was no association between maternal lipid levels during pregnancy and delivery of SGA,(12, 16, 17) whereas other reports found that gestational dyslipidemia could lead to SGA infant birth (11)(12)(13)(14)(15)18).…”

Prevention Starts in the Womb: Opportunities for Addressing Cardiovascular Risk Factors During Pregnancy and Beyond

“…Based on these results, low prepregnancy cholesterol may be a marker of poor nutritional status or a baseline inflammatory state that leads to PTB-inducing cascade, whereas high prepregnancy cholesterol represents a “proatherogenic phenotype” with increased risk of PTB. 35 …”

The mediating role of maternal metabolites between lipids and adverse pregnancy outcomes of gestational diabetes mellitus

“…However, no correlations were observed between low-density lipoprotein cholesterol (LDL-C) or total cholesterol (TC) levels and adverse neonatal pregnancy outcomes ( 13 ). Another study in China showed that TC levels during the third trimester of pregnancy were associated with a lower risk of SGA, whereas HDL-C and LDL-C levels during late pregnancy were associated with an increased risk of SGA ( 14 ). Several studies have shown that in well-controlled GDM, maternal TG concentration is positively correlated with newborn fat mass and LGA ( 15 , 16 ).…”