Maternal lipids at mid‐pregnancy and the risk of preterm delivery

Mudd, Lanay M.; Holzman, Claudia; Catov, Janet M.; Senagore, Patricia K.; Evans, Rhobert W.

doi:10.1111/j.1600-0412.2012.01391.x

Cited by 91 publications

(99 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Low maternal HDL-C in early pregnancy has also been associated with increased risk of later GDM (23), and elevated HDL-C has been associated with lower rates of preterm birth (24). Both low (,10th centile) and high (.90th centile) maternal total cholesterol have been associated with preterm birth (6,25), with one study showing a trend to increased rates of microcephaly for low (,10th centile) maternal cholesterol (25) ( Table 2). Overall, there is good evidence that elevated triglycerides and low levels of HDL-C are associated with adverse maternal and neonatal outcomes for women without diabetes.…”

Section: Maternal Obesitymentioning

confidence: 99%

“…However, it has not been accorded the same attention in pregnancy. Abnormal maternal lipids in pregnancy have been associated with preeclampsia (4,5), preterm delivery (6), and large-forgestational-age (LGA) infants (7). This review examines the dyslipidemia associated with pregnancy complicated by diabetes, reviews possible therapies, and considers whether there is sufficient evidence to start actively managing lipids in pregnancy.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Normalizing Metabolism in Diabetic Pregnancy: Is It Time to Target Lipids?

et al. 2014

View full text Add to dashboard Cite

Outcomes in pregnancies complicated by preexisting diabetes (type 1 and type 2) and gestational diabetes mellitus have improved, but there is still excess morbidity compared with normal pregnancy. Management strategies appropriately focus on maternal glycemia, which demonstrably improves pregnancy outcomes for mother and infant. However, we may be reaching the boundaries of obtainable glycemic control for many women. It has been acknowledged that maternal lipids are important in pregnancies complicated by diabetes. Elevated maternal lipids are associated with preeclampsia, preterm delivery, and large-forgestational-age infants. Despite this understanding, assessment of management strategies targeting maternal lipids has been neglected to date. Consideration needs to be given to whether normalizing maternal lipids would further improve pregnancy outcomes. This review examines the dyslipidemia associated with pregnancy complicated by diabetes, reviews possible therapies, and considers whether it is time to start actively managing this aspect of maternal metabolism.Although rates of adverse outcomes in pregnancies complicated by preexisting diabetes (type 1 and type 2) and gestational diabetes mellitus (GDM) have improved, there is still excess maternal and fetal morbidity compared with normal pregnancy. Current management strategies focus on maternal glycemic control, which demonstrably improves pregnancy outcomes for mother and infant. Truly "normal" glucose levels in pregnancy appear lower than previously thought (1) and achieving currently recommended glucose targets in pregnancy carries a risk of hypoglycemia (2). The challenges in reaching glycemic targets before and after conception raise the question of whether other aspects of maternal metabolism could potentially be addressed to provide benefit to mother and infant.Multiple maternal metabolic, hormonal, and inflammatory factors other than maternal glucose are associated with maternal and fetal outcomes and are altered in pregnancies complicated by prepregnancy diabetes and GDM. These include maternal amino acids, glycerol, ketones, and lipids (3). Lipid management in diabetes is acknowledged as a key therapeutic target in the nonpregnant setting. However, it has not been accorded the same attention in pregnancy. Abnormal maternal lipids in pregnancy have been associated with preeclampsia (4,5), preterm delivery (6), and large-forgestational-age (LGA) infants (7). This review examines the dyslipidemia associated with pregnancy complicated by diabetes, reviews possible therapies, and considers whether there is sufficient evidence to start actively managing lipids in pregnancy. LIPID METABOLISM IN PREGNANCYMaternal metabolism is designed to provide adequate nutrition for fetal growth, in the form of glucose, ketones, lipids, and other fuels. In early pregnancy, maternal

show abstract

Section: Maternal Obesitymentioning

confidence: 99%

mentioning

confidence: 99%

Normalizing Metabolism in Diabetic Pregnancy: Is It Time to Target Lipids?

et al. 2014

View full text Add to dashboard Cite

show abstract

“…21 Hence, with respect to each variable analyzed, these correlations make it possible for the reader to identify the events caused by maternal overweight and to deem dyslipidemic alternations as indicators of complications, such as predisposition to high systemic arterial blood pressure, cardiometabolic events and the outcomes of a premature delivery. 18,22,23 Dyslipidemic complications in preterm birth Even though changes in pregnancy are evident, the likelihood of a clinical and physiological imbalance during the gestational period is indisputable. It is therefore essential that pregnant women be followed up and have their weight controlled to ensure both maternal and fetal health.…”

Section: Metabolic Changes and Gestational Dyslipidemiamentioning

confidence: 99%

“…It is therefore essential that pregnant women be followed up and have their weight controlled to ensure both maternal and fetal health. 1,3 Mudd et al 22 demonstrated an existing relationship between There is an established link between TNF-α and the release of lipids by adipocytes, i.e. TNF-α being induced by lipolysis.…”

Section: Metabolic Changes and Gestational Dyslipidemiamentioning

confidence: 99%

“…In other words, while some studies reported high risks or a diminished relationship, other studies found no correlation at all. 22,25,26,28 Nevertheless, some researchers state that prematurity is independent of maternal hyperglycemia, 5 suggesting thus that it is more closely associated with maternal dyslipidemia.…”

Section: Metabolic Changes and Gestational Dyslipidemiamentioning

confidence: 99%

See 1 more Smart Citation

Dyslipidemia and maternal obesity: Prematurity and neonatal prognosis

Nascimento

Souza

Silva

et al. 2018

Rev. Assoc. Med. Bras.

View full text Add to dashboard Cite

NascimeNto iB et al. 264Rev assoc med Objective: To identify the changes caused by dyslipidemia and obesity in pregnancy suggesting causes for premature birth, and the prognosis for the newborn. Method: Systematic review based on the Medline, Lilacs, Embase and Cochrane library databases between 1996 and 2016. The search for studies included the following keywords: "dyslipidemia, pregnancy, obesity, preterm birth." A protocol was programmed and a protocol for inclusion/exclusion of studies was implemented. Results: Of the 5,789 articles initially selected between March 1996 and July 2016, only 32 were in accordance with the established criteria. Of these, 28.12% discussed risk factors of prematurity; 37.50%, metabolic alterations and gestational dyslipidemia; 21.87%, dyslipidemic complications in preterm birth; and 12,50%, lipid metabolism, glycemic and placental transfer. Conclusion:There is a reduced adaptation of obese pregnant women to the metabolic changes of gestation. This favors dyslipidemic intercurrences in the mother, which, directly or indirectly, suggests the occurrence of premature births and high lipid transfer to the fetus. Therefore, preterm newborns, whose mothers were dyslipidemic during pregnancy, have greater risk of epicardial fat, both in early (first year of life) and in later (adult) phases of life.

show abstract