Maternal and fetal blood lipid concentrations during pregnancy differ by maternal body mass index: findings from the ROLO study

Abstract

BackgroundPregnancy is a time of altered metabolic functioning and maternal blood lipid profiles change to accommodate the developing fetus. While these changes are physiologically necessary, blood lipids concentrations have been associated with adverse pregnancy outcomes such as gestational diabetes, pregnancy-induced hypertension and high birth weight. As blood lipids are not routinely measured during pregnancy, there is limited information on what is considered normal during pregnancy and in fetal blood.MethodsData from 327 mother-child pairs from the ROLO longitudinal birth cohort study were analysed. Fasting total cholesterol and triglycerides were measured in early and late pregnancy and fetal cord blood. Intervals were calculated using the 2.5th, 50th and 97.5th centile. Data was stratified based on maternal body mass index (BMI) measured during early pregnancy. Differences in blood lipids between BMI categories were explored using ANOVA and infant outcomes of macrosomia and large-for-gestational-age (LGA) were explored using independent student T-tests and binary logistic regression.ResultsAll maternal blood lipid concentrations increased significantly from early to late pregnancy. In early pregnancy, women with a BMI < 25 kg/m2 had lower concentrations of total cholesterol compared to women with a BMI of 25–29.9 kg/m2 (P = 0.02). With triglycerides, women in the obese category (BMI > 30 kg/m2) had higher concentrations than both women in the normal-weight and overweight category in early and late pregnancy (P < 0.001 and P = 0.03, respectively). In late pregnancy, triglyceride concentrations remained elevated in women in the obese category compared to women in the normal-weight category (P = 0.01). Triglyceride concentrations were also elevated in late pregnancy in mothers that then gave birth to infants with macrosomia and LGA (P = 0.01 and P = 0.03, respectively).ConclusionBlood lipid concentrations increase during pregnancy and differ by maternal BMI. These intervals could help to inform the development of references for blood lipid concentrations during pregnancy.Trial registrationROLO Study - ISRCTN54392969. Date of registration: 22/04/2009.

Maternal plasma lipid levels across pregnancy and the risks of small-for-gestational age and low birth weight: a cohort study from rural Gambia

“…These findings suggest that dietary interventions to improve diet and increase cholesterol levels during pregnancy may promote fetal growth and reduce adverse birth weight-related outcomes. Consistent with previous studies, we observed an increase in plasma TC, LDL-c and TG levels across pregnancy [10,16,17,26,27], which is known to be part of a normal physiological response to gestation [28]. However, unlike in studies from higher-income countries [10,27,28], our data show a decrease in HDL-c levels from 20 to 30 weeks gestation, following an initial rise across the first half of pregnancy.…”

“…Previous investigations examining potential associations between maternal lipid levels and birth weight have mostly focused on the second trimester of pregnancy and have often used lipid measurements from a single gestational time-point. When compared to mid-range values, low total cholesterol levels (TC) have been associated with lower birth weight [12,14] and greater risk of LBW [15], and high TC [12,16] or high triglycerides (TG) levels with higher birth weight [12,[15][16][17][18][19]. In a case-control study conducted in Canada, higher mean levels of high-density lipoprotein (HDL) particles in the second trimester were found in women with term-born SGA infants compared to women with AGA infants [20].…”

Gestational Diabetes Mellitus Treatment Schemes Modify Maternal Plasma Cholesterol Levels Dependent to Women´s Weight: Possible Impact on Feto-Placental Vascular Function

“…Regarding the lipid profile, all of the studied groups showed increased TC, LDL and TG levels during pregnancy, as previously reported for the women in group C and women with GDM [15,16]. This physiological change is required to fulfill all of the needs of the developing fetus [25,30,[73][74][75][76][77][78][79][80][81][82].…”

Management of prepregnancy, pregnancy, and postpartum obesity from the FIGO Pregnancy and Non‐Communicable Diseases Committee: A FIGO (International Federation of Gynecology and Obstetrics) guideline

“…Comorbidities such as gestational diabetes mellitus (GDM) are more common in pregnant women with obesity, and this not only increases the risk of subsequent type 2 diabetes mellitus for the mother but also leads to increased fetal growth, large‐for‐gestational‐age babies, and metabolic compromise in the offspring 11–14 . These outcomes in offspring are further associated with long‐term consequences such as childhood obesity and type 2 diabetes mellitus in later life 15 .…”