Maternal lipid profile in early pregnancy is associated with foetal growth and the risk of a child born large-for-gestational age: a population-based prospective cohort study

Adank, Maria C.; Benschop, Laura; Kors, Alet W.; Peterbroers, Kelly R.; Gregoor, Anna M. Smak; Mulder, Monique; Schalekamp‐Timmermans, Sarah; Lennep, Jeanine E. Roeters van; Steegers, Eric A.P.

doi:10.1186/s12916-020-01730-7

Cited by 56 publications

(52 citation statements)

References 71 publications

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“…The findings were not explained by maternal BMI, suggesting effects of maternal cholesterol and triglyceride concentrations within the normal range were independent of BMI. In line with our findings, results from the same study cohort also showed that maternal triglyceride and cholesterol levels are associated with increased fetal growth rates which resulted in a higher birth weight [40]. These findings might suggest that these increased maternal lipid levels have consequences for fetal cardiac development and might lead to persistent subclinical consequences in childhood.…”

Section: Maternal Weight Gain During Pregnancysupporting

confidence: 90%

Associations of maternal metabolic profile with placental and fetal cerebral and cardiac hemodynamics

Kooijman¹,

Jaddoe²,

Steegers

et al. 2021

European Journal of Obstetrics & Gynecology and Reproductiv

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Maternal obesity and metabolic health affect pregnancy outcomes. We examined whether maternal metabolic profiles are associated with placental and fetal hemodynamics. Study Design: In a population-based prospective cohort study among 1175 women we examined the associations of an adverse maternal metabolic profile in early pregnancy with placental, fetal cerebral and cardiac hemodynamic development. We obtained maternal pre-pregnancy BMI by questionnaire and measured blood pressure, cholesterol, triglycerides and glucose concentrations at a median gestational age of 12.6 (95 % range 9.6-17.1) weeks. An adverse maternal metabolic profile was defined as !4 risk factors. Placental and fetal hemodynamics were measured by pulsed-wave-Doppler at a median gestational age of 30.3 (95 % range 28.8-32.3) weeks. Results: An adverse maternal metabolic profile was associated with a 0.29 Z-score higher (95 %CI 0.08À0.50) fetal cerebral middle artery pulsatility index (PI), but not with placental or fetal cardiac hemodynamic patterns. When the individual components of an adverse maternal metabolic profile were assessed, we observed that higher maternal total cholesterol and triglyceride concentrations were associated with a higher cerebral middle artery PI (Z-score, 0.09 (95 %CI 0.02À0.15), 0.09 (95 %CI 0.03À0.15) per Z-score increase). Higher total and HDL maternal cholesterol concentrations were also associated with a higher aorta ascendens peak systolic velocity (PSV) Z-score, 0.08 (95 %CI 0.01À0.14)), and a larger left cardiac output (Z-score, 0.08 (95 %CI 0.00À0.15), respectively). Conclusion: An adverse maternal metabolic profile, especially higher cholesterol and triglycerides concentrations, are associated with increased fetal cerebral vascular resistance and larger fetal aorta ascendens diameter, PSV and left cardiac output, but not with placental vascular resistance indices. Further studies are needed to identify long-term consequences of the observed associations.

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Section: Maternal Weight Gain During Pregnancysupporting

confidence: 90%

Associations of maternal metabolic profile with placental and fetal cerebral and cardiac hemodynamics

Kooijman¹,

Jaddoe²,

Steegers

et al. 2021

European Journal of Obstetrics & Gynecology and Reproductiv

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“…Under normal physiological conditions, over the duration of a pregnancy there is a visible increase in lipid concentrations, including in TG and CHL [ 44 ]. Adank et al [ 45 ] conducted a study on pregnant women and found a correlation between the concentrations of TG and remnant cholesterol in early pregnancy and increased fetal body weight and risk of having large for gestational age (LGA) infants. It has been shown in mice that circulating TG, HDL, and total CHL are increased by the gut microbiota under conditions of a high-fat diet [ 46 ].…”

Section: Discussionmentioning

confidence: 99%

Implications of SCFAs on the Parameters of the Lipid and Hepatic Profile in Pregnant Women

2021

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Short-chain fatty acids (SCFAs) are the product of the anaerobic intestinal bacterial fermentation of dietary fiber and resistant starch. An abnormal intestinal microbiota may cause a reduction in the production of SCFAs, which stimulate the development of intestinal epithelial cells, nourish enterocytes, influence their maturation and proper differentiation, reduce the pH, and are an additional source of energy for the host. There have been reports of the special role of SCFAs in the regulation of glucose and lipid metabolism during pregnancy. Aim: The aim of the study was to analyze the correlation of SCFAs with lipid and hepatic metabolism during pregnancy in relation to the body weight of pregnant women. Material and methods: This study was conducted in pregnant women divided into two groups: Obese (OW—overweight and obese women; n = 48) and lean (CG—control group; n = 48) individuals. The biochemical plasma parameters of lipid metabolism (TG, CH, LDL, HDL), inflammation (CRP), and liver function (ALT, AST, GGT) were determined in all of the subjects. SCFA analysis was performed in the stool samples to measure acetic acid (C 2:0), propionic acid (C 3:0), isobutyric acid (C 4:0 i), butyric acid (C 4:0 n), isovaleric acid (C 5:0 i) valeric acid (C 5:0 n), isocaproic acid (C 6:0 i), caproic acid (C 6:0 n), and heptanoic acid (C 7:0). Results: Statistically significant differences in the concentrations of C 3:0 and C 6:0 n were found between women in the OW group compared to the CG group. The other SCFAs tested did not differ significantly depending on BMI. The C 2:0, C 3:0, and C 4:0 n ratios showed differences in both OW and CG groups. In the OW group, no relationship was observed between the concentrations of the SCFAs tested and CRP, ALT, AST. A surprising positive relationship between C 5:0 n and all fractions of the tested lipids and branched C 5:0 with CHL, HDL, and LDL was demonstrated. In the OW group, HDL showed a positive correlation with C 3:0. However, lower GGT concentrations were accompanied by higher C 4:0 and C 5:0 values, and this tendency was statistically significant. Conclusions: The results of our research show that some SCFAs are associated with hepatic lipid metabolism and CRP concentrations, which may vary with gestational weight. Obesity in pregnancy reduces the amount of SCFAs in the stool, and a decrease in the level of butyrate reduces liver function.

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“…A prospective study by Adank et al. [ 28 ] with 5702 pregnant women showed that early pregnancy TG level was associated with slight increase of risk of large-for-gestational age (LGA) (OR: 1.18, 95% CI: 1.07–1.29). Although maternal circulating TG does not directly cross the placenta, the presence of lipoprotein receptors, fatty acid–binding proteins, and different lipase activities in the placenta enable efficient transfer of maternal fatty acids to the foetus [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Establishment of trimester-specific reference intervals of serum lipids and the associations with pregnancy complications and adverse perinatal outcomes: a population-based prospective study

Zhao

et al. 2021

Annals of Medicine

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Background Disturbances in maternal lipid metabolism may increase the risk of developing pregnancy complications and adverse perinatal outcomes. However, there is no consensus as to what constitutes normal serum lipid ranges during pregnancy. Our study was aimed to establish trimester-specific serum lipid reference intervals (RIs) and investigate the associations between maternal dyslipidaemia and adverse outcomes in a population-based study. Methods The first- and third-trimester lipid profiles were derived from 16,489 singlet pregnant women for regular antenatal check-ups between 2017 and 2019. The serum samples were assayed for total cholesterol (TC), triglycerides (TG), high-density lipoprotein-cholesterol (HDL-C), and low-density lipoprotein-cholesterol (LDL-C) in the institutional clinical laboratory. The trimester-specific lipid RIs were estimated with both of the direct observational and the indirect Hoffmann methods. The associations between maternal lipid profiling and pregnancy complications and perinatal outcomes were assessed statistically. Results Serum levels of TC, TG, LDL-C and HDL-C were all increased significantly in the third trimester of pregnancy. There was no significant difference between the observed RIs established with healthy pregnant women and the calculated RIs derived from the Hoffmann method. A trend towards increased risks of gestational complications and adverse perinatal outcomes was observed in the subjects with elevated levels of TC, TG, and LDL-C or decreased level of HDL-C. Conclusions In pregnancy, increased serum levels of TC, TG and LDL-C, and a decreased level of HDL-C posed higher risks of developing pregnancy complications and adverse perinatal outcomes. Key messages It is necessary to establish trimester-specific reference intervals for serum lipids including TC, TG, LDL-C and HDL-C that were found significantly increased as the gestational age went up. More importantly, around the upper reference limits of TC, TG and LDL-C (or the lower reference limit of HDL-C), the higher the serum lipid levels were (or the lower the HDL-C level was), the higher risks of developing pregnancy complications and adverse perinatal outcomes were observed.

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Maternal lipid profile in early pregnancy is associated with foetal growth and the risk of a child born large-for-gestational age: a population-based prospective cohort study

Cited by 56 publications

References 71 publications

Associations of maternal metabolic profile with placental and fetal cerebral and cardiac hemodynamics

Associations of maternal metabolic profile with placental and fetal cerebral and cardiac hemodynamics

Implications of SCFAs on the Parameters of the Lipid and Hepatic Profile in Pregnant Women

Establishment of trimester-specific reference intervals of serum lipids and the associations with pregnancy complications and adverse perinatal outcomes: a population-based prospective study

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