Associations between maternal lipid profile and pregnancy complications and perinatal outcomes: a population-based study from China

Abstract

BackgroundDyslipidemia in pregnancy are associated with gestational diabetes mellitus (GDM), preeclampsia, preterm birth and other adverse outcomes, which has been extensively studied in western countries. However, similar studies have rarely been conducted in Asian countries. Our study was aimed at investigating the associations between maternal dyslipidemia and adverse pregnancy outcomes among Chinese population.MethodsData were derived from 934 pairs of non-diabetic mothers and neonates between 2010 and 2011. Serum blood samples were assayed for fasting total cholesterol (TC), triglycerides (TG), high-density lipoprotein-cholesterol (HDL-C), and low-density lipoprotein-cholesterol (LDL-C) concentrations during the first, second and third trimesters. The present study explored the associations between maternal lipid profile and pregnancy complications and perinatal outcomes. The pregnancy complications included GDM, preeclampsia and intrahepatic cholestasis of pregnancy (ICP); the perinatal outcomes included preterm birth, small/large for gestational age (SGA/LGA) infants and macrosomia. Odds ratios (ORs) and 95 % confidence intervals (95 % CIs) were calculated and adjusted via stepwise logistic regression analysis. Optimal cut-off points were determined by ROC curve analysis.ResultsAfter adjustments for confounders, every unit elevation in third-trimester TG concentration was associated with increased risk for GDM (OR = 1.37, 95 % CI: 1.18-1.58), preeclampsia (OR = 1.50, 95 % CI: 1.16-1.93), ICP (OR = 1.28, 95 % CI: 1.09-1.51), LGA (OR = 1.13, 95 % CI: 1.02-1.26), macrosomia (OR = 1.19, 95 % CI: 1.02-1.39) and decreased risk for SGA (OR = 0.63, 95 % CI: 0.40-0.99); every unit increase in HDL-C concentration was associated with decreased risk for GDM and macrosomia, especially during the second trimester (GDM: OR = 0.10, 95 % CI: 0.03-0.31; macrosomia: OR = 0.25, 95 % CI: 0.09-0.73). The optimal cut-off points for third-trimester TG predicting GDM, preeclampsia, ICP, LGA and SGA were separately ≥3.871, 3.528, 3.177, 3.534 and ≤2.530 mmol/L. The optimal cut-off points for third-trimester HDL-C identifying GDM, macrosomia and SGA were respectively ≤1.712, 1.817 and ≥2.238 mmol/L.ConclusionsAmong Chinese population, maternal high TG in late pregnancy was independently associated with increased risk of GDM, preeclampsia, ICP, LGA, macrosomia and decreased risk of SGA. Relative low maternal HDL-C during pregnancy was significantly associated with increased risk of GDM and macrosomia; whereas relative high HDL-C was a protective factor for both of them.

Vitamin D₃-Supplemented Yogurt Drink Improves Insulin Resistance and Lipid Profiles in Women with Gestational Diabetes Mellitus: A Randomized Double Blinded Clinical Trial

“…In addition, lipid compositions, such as TAG, TC and LDL as well as the TC/HDL ratio, exhibited significant reductions. Since these lipid composition parameters were reported to serve as potential biomarker for the prediction of GDM [19] , in particular high HDL level was found to be a beneficial factor for GDM [20] , our findings suggest that the observed changes in lipid composition were beneficial for pregnant GDM women.…”

Feto-maternal impact of altered lipid profile in pregnancy

“…[6][7][8][9][10][11] Jin WY et al, Saha D et al, Saxena S et al, Vidyabati RK, Islam NAF and Aziz R they all agree on the fact that dyslipidemia was significantly associated with pre eclampdia and eclampsia. [6][7][8][9][10][11] As hypertensive disorder developed, there was development of fetal complications. The women with severe dyslipidemia developed fetal complication of severe IUGR and IUD in their late second and early third trimester with very poor outcome.…”

Lipids in Hypertensive Disorders of Pregnancy and Birth Weight

“…Though it was thought that higher maternal serum lipids in pregnancy lead to fetal macrosomia, but in hostile environment like HDsP, lipid abnormalities might lead to small babies due to poor endothelial function [30]. One Asian study revealed that maternal serum lipids in pregnancy acted as an independent factor for PE in the later gestation which further affected the fetal outcome including birth weight [31].…”