Cardiovascular biochemical risk factors among women with spontaneous preterm delivery

Heida, Karst Y.; Kampman, M. A. M.; Franx, Arie; Laat, Monique W. De; Mulder, Barbara J.M.; Post, Joris A. M. van der; Bilardo, C. M.; Pieper, Petronella G.; Sollie, Krystyna M.; Sieswerda, Gertjan T.; Ris‐Stalpers, Carrie; Oudijk, Martijn A.

doi:10.1002/ijgo.12423

Cited by 5 publications

(5 citation statements)

References 27 publications

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“…Pregnancies with poorly controlled GDM have also been shown to have higher rates of preterm delivery compared to normal pregnancies [23]. Lastly, higher average glucose values are seen in normal pregnancies who experience spontaneous preterm delivery compared to controls with spontaneous term labor [24]. Applied to our findings, the above hypothesis would argue that the lower glycemic target group allowed more GDM pregnancies to reach 39 weeks, at which point they were recommended for induction of labor.…”

Section: Discussionmentioning

confidence: 53%

The Utility of Lower Glycemic Targets for Treating Gestational Diabetes: A Retrospective Study

Hagen

Brown

Dietrich

et al. 2019

Journal of Diabetes Research

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Objective In vivo study of glucose homeostasis in pregnancy suggests normal glucose levels are lower than current glycemic targets used in gestational diabetes. After the HAPO study results, our institution began using glycemic targets of fasting 85 mg/dL and 2-hour postprandial of 110 mg/dL. We reviewed our results. Methods A retrospective cohort of GDM patients that delivered at KUMC from January 2007 to May 2017 was reviewed. All patients were diagnosed with the 2-step Carpenter-Coustan thresholds. High targets were compared with low targets. The primary outcome investigated was birthweight > 90% (large for gestational age, LGA). Results 604 patients were studied, and 34% were treated with low glycemic targets. Our unadjusted results showed that the low-target group had a lower incidence of LGA infants (24.0 vs. 31.8%), higher incidence of neonatal hypoglycemia (20.7 vs. 11.6%), and inductions (39.4 vs. 20.5%). After adjustment for demographic variables, only a higher risk of inductions remained (aOR 2.54 (1.44, 4.49)). Conclusion Lower glycemic targets did not produce large reductions in fetal overgrowth, but they were associated with a higher rate of inductions. As there were no observed differences in maternal or neonatal outcomes otherwise, aiming for lower glycemic targets in GDM is likely not cost-effective.

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Section: Discussionmentioning

confidence: 53%

The Utility of Lower Glycemic Targets for Treating Gestational Diabetes: A Retrospective Study

Hagen

Brown

Dietrich

et al. 2019

Journal of Diabetes Research

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“…However, the evidence from this study would indicate that our current scientific understanding of the relationship between lipid metabolism, PTB, and genetics is incomplete. Although some studies have found increased risk for PTB among women with low TC during pregnancy or at delivery, (Edison et al, ; Heida et al, ; Oluwole et al, ) associations between high HDL‐C or low TAG and increased risk for PTB have not been previously identified. In interpreting these findings, it is important to recognize the degree to which the GRS explain variability in the lipid profile.…”

Section: Discussionmentioning

confidence: 99%

Genetic Risk Scores for Maternal Lipid Levels and Their Association with Preterm Birth

Smith

Jasper

Baer

et al. 2019

Lipids

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Maternal lipid profiles are associated with risk for preterm birth (PTB), although the lipid component and effect size are inconsistent between studies. It is also unclear whether these associations are the result of excessive changes in lipid metabolism during pregnancy or genetic variability in genes controlling basal lipid metabolism. This study investigates the association between genetic risk scores (GRS) for four lipid components (high‐density lipoprotein [HDL‐C], low‐density lipoprotein [LDL‐C], triacylglycerols [TAG], and total cholesterol [TC]) with risk for PTB. Subjects included 954 pregnant women from California for whom second trimester serum samples were available, of which 479 gave birth preterm and 475 gave birth at term. We genotyped 96 single‐nucleotide polymorphisms, which were selected from genome‐wide association studies of lipid levels in adult populations. Lipid‐specific GRS were constructed for HDL‐C, LDL‐C, TAG, and TC. The associations between GRS and PTB were analyzed using logistic regression. A higher HDL‐C GRS was associated with increased risk for PTB overall and spontaneous PTB. Higher TAG and TC GRS were associated with decreased risk for PTB overall and spontaneous PTB. This study identifies counter‐intuitive associations between lipid GRS and spontaneous PTB. Further replication studies are needed to confirm these findings, but they suggest that our current scientific understanding of the relationship between lipid metabolism, PTB, and genetics is incomplete.

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“…Kaser et al (2001) evaluated lipid levels in infants and reported small for gestational age (SGA) neonates to have lower HDL, LDL, and TC levels, compared to appropriate for gestational age (AGA) infants [27]. Moreover, Heida et al (2017) found no correlations between spontaneous preterm delivery and unfavourable lipid levels or cardiovascular biochemical risk factors in mothers [14]. Grace et al (2017) examined the relationship between maternal serum lipoproteins and gestational age, and reported LDL and HDL concentrations to be independently related with gestational age at preterm delivery [28].…”

Section: Discussionmentioning

confidence: 99%

“…A systematic review found that the risk of spontaneous preterm delivery could be increased by high TG levels, but was not affected by HDL-C and LDL-C levels [13]. Meanwhile, Heida et al (2017) reported lower TC and LDL-C levels in women with spontaneous preterm delivery, but could not establish a significant relationship between undesirable lipid levels and preterm delivery [14]. Since changes in fat metabolism during pregnancy can be associated with adverse pregnancy outcomes, this review aimed to determine the association between lipid profiles during pregnancy and preterm delivery.…”

Section: Introductionmentioning

confidence: 99%

The relationship between lipid profiles in pregnancy and preterm delivery: a systematic review

2018

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Background: High-density lipoprotein (HDL), low-density lipoprotein (LDL), triglyceride (TG), and total cholesterol (TC) are associated with maternal hormonal changes which can lead to pregnancy complications. High lipid levels during pregnancy may be accompanied by an increased risk of spontaneous preterm labor. The purpose of this review was to determine the relationship between lipid profiles in pregnancy and preterm delivery. Methods: A systematic search was performed in PubMed, EMBASE, Web of Science, Scopus, and Science Direct databases to find cross-sectional, case-control, and cohort studies on the associations between lipid profiles in pregnancy and preterm delivery. The search results were limited to papers published during 2000-2018. The quality of the selected studies was assessed based on the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. Finally, a total of 25 eligible high-quality papers were reviewed. Results: A high maternal TG level in the first trimester of pregnancy was identified as a significant risk factor for preterm delivery. Low TG, HDL-cholesterol (HDL-C) and LDL-cholesterol (LDL-C) levels were uniquely associated with an increased risk of preterm delivery. High TC, TG, and LDL-C levels increased the risk of spontaneous preterm labor. A further association was found between high TG and TC levels and an elevated risk of preterm labor before 34 weeks of gestation. The risk of preterm labor before 34 weeks and during the 34th-37th weeks of gestation increased with increasing TG and TC levels. Moreover, overweight women who had a delivery before 34 weeks exhibited significant increases in TC and LDL concentrations during early pregnancy. Conclusion: Lipid metabolism undergoes complicated changes in pregnancy. Lipid levels (LDL, HDL, TC, and TG) above or below the normal range during pregnancy increase the risk of preterm delivery. Considering the significance of maternal lipid metabolism in the incidence of preterm delivery, lipid profile screening in early pregnancy can largely contribute to the prevention of preterm delivery. Further studies are warranted to meticulously examine the effects of lipid profile on preterm delivery.

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Cardiovascular biochemical risk factors among women with spontaneous preterm delivery

Abstract: An association between sPTD and unfavorable lipids and cardiovascular biochemical risk factors was not established. The higher levels of glucose in the sPTD group might be due to increased insulin resistance, which is associated with a higher risk of sPTD.

Cited by 5 publications

References 27 publications

The Utility of Lower Glycemic Targets for Treating Gestational Diabetes: A Retrospective Study

The Utility of Lower Glycemic Targets for Treating Gestational Diabetes: A Retrospective Study

Genetic Risk Scores for Maternal Lipid Levels and Their Association with Preterm Birth

The relationship between lipid profiles in pregnancy and preterm delivery: a systematic review

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