Clustering of metabolic risk factors and adverse pregnancy outcomes: a prospective cohort study

Lei, Qiong; Niu, Jianmin; Lv, Lijuan; Duan, Dongmei; Wen, Jiying; Lin, Xiaohong; Mai, Caiyuan; Zhou, Yuheng

doi:10.1002/dmrr.2803

Cited by 49 publications

(62 citation statements)

References 41 publications

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“…Furthermore, in the study by Grieger et al, diagnosis of MetS was not associated with increased risk at lower gestational ages (9). However, in the study by Lei et al., metabolic abnormalities in pregnancy were associated with adverse pregnancy such as preterm labor (29). The reason for the difference in the results of these studies is that there is no single definition for the metabolic syndrome in pregnancy and different measurements have been carried out to diagnose the metabolic syndrome.…”

Section: Discussionmentioning

confidence: 96%

Are maternal metabolic syndrome and lipid profile associated with preterm delivery and preterm premature rupture of membranes?

Moghaddam-Banaem¹,

Niyaty

Sourinejad

et al. 2019

Preprint

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Objectives We aimed to evaluate the association of metabolic syndrome (MetS), its components and lipid profile in mid-pregnancy with preterm delivery and preterm premature rupture of membranes (PPROM).Methods This prospective cohort study was conducted on 203 pregnant women between 24-28 weeks of gestation, undergoing the gestational diabetes screening test with 50 gr glucose challenge test (GCT). Fasting serum total cholesterol, low-density lipoprotein cholesterol (LDL-C), high -density lipoprotein cholesterol (HDL-C), and triglyceride (TG) levels were measured during the week after GCT assessment. Information on the participants' pre-pregnancy weight, demographic/ reproductive characteristics, and height and blood pressure (BP) measurements were documented at baseline entry into the study. Metabolic syndrome was defined as the co-existence of 3 or more of the following criteria: Body mass index (BMI) before pregnancy≥30 kg/m2, BP≥130/85 mmHg, GCT≥140mg/dl, TG≥150mg/dl, and HDL-C≤50mg/dl. All participants were followed through routine prenatal care, up to delivery. Any deliveries or rupture of membranes of less than or equal to weeks of pregnancy, were considered preterm delivery and PPROM respectively. Statistical analysis was performed by SPSS V.20, and p-value of less than 0.05 was considered significant.Results MetS was detected in 10 (4.9%) of participants. Logistic regression analysis showed HDL-C levels, and hypertension had significant effects on preterm delivery occurrence [(OR: 0.952, 95%CI: 0.910_0.995), (OR: 1.629, 95% CI: 1.554_1.709) respectively], but no statistically significant results were found for PPROM.Conclusions Low HDL-C levels and hypertension in mid-pregnancy may increase the occurrence of preterm deliveries, indicating that MetS and its components should be monitored more closely in pregnancy.

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Section: Discussionmentioning

confidence: 96%

Are maternal metabolic syndrome and lipid profile associated with preterm delivery and preterm premature rupture of membranes?

Moghaddam-Banaem¹,

Niyaty

Sourinejad

et al. 2019

Preprint

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“…The associations between lipid components and PTB have been inconsistent across multiple studies (Alleman et al, ; Chatzi et al, ; Edison et al, ; Emet et al, ; Jelliffe‐Pawlowski et al, ; Jin et al, ; Kramer et al, ; Lei et al, ; Maymunah et al, ; Mudd et al, ; Niromanesh et al, ; Oluwole et al, ; Vrijkotte et al, ). These studies are centered on the hypothesis that extreme metabolic changes in pregnancy, as reflected by lipid profiles, confer increased risk for PTB.…”

Section: Introductionmentioning

confidence: 99%

“…These studies vary greatly in the lipid components that were measured, the gestational age at which they were measured, the inclusion and exclusion criteria, and the fasting status of the measurements, which likely contribute to their inconsistent results. Studies of maternal lipid profiles in late‐first to early‐second trimester found that low HDL‐C (Jelliffe‐Pawlowski et al, ; Kramer et al, ; Lei et al, ), high TAG (Jelliffe‐Pawlowski et al, ; Lei et al, ; Mudd et al, ; Niromanesh et al, ), low TC (Edison et al, ; Oluwole et al, ) or high TC (Maymunah et al, ; Mudd et al, ), and high LDL‐C:HDL‐C (Chatzi et al, ) were associated with increased risk for PTB. A recent meta‐analysis of these studies found that elevated TC, elevated TAG, and low HDL‐C were significantly associated with increased risk for PTB, with significant odds ratios ranging from 1.33 to 1.71 (Jiang et al, ).…”

Section: Introductionmentioning

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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“…Lei et al performed a prospective cohort study of 5,535 women in Guangdong Province in China. 91 92 Failure to do so may explain why an association was identified in the larger racial group, White women, and not in the smaller racial group, Black women, if TC distributions differed between these groups. Maymunah et al performed a prospective cohort of 287 women screened between 14-20 weeks' gestation in Lagos, Nigeria.…”

Section: Maternal Lipid Levels and Risk For Preterm Birthmentioning

confidence: 99%

“…100,101 The associations between lipid components and preterm birth have been inconsistent across multiple studies. [82][83][84][85][86][87][88][89][90][91][92][93][94] These studies are centered on the hypothesis that extreme metabolic changes in pregnancy, as reflected by lipid profiles, confer increased risk for preterm birth. These studies vary greatly in the lipid components that were measured, the gestational age at which they were measured, the inclusion and exclusion criteria, and the fasting status of the measurements, which likely contribute to their inconsistent results.…”

Section: Maternal Lipid Levels and Risk For Preterm Birthmentioning

confidence: 99%

Genetic and metabolic associations with preterm birth

Smith¹

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Preterm birth is defined as delivery prior to 37 weeks' completed gestation. It affects an average of 11% of pregnancies worldwide and is the leading cause of death in children under age 5. Many studies have identified associations between pregnancy lipid levels and increased risk for preterm birth. This thesis investigates the role of genetic variability associated with lipids and its relationship with preterm birth, and the relationship between pre-pregnancy dyslipidemia and risk for preterm birth. Genetic variability in the form of single-nucleotide polymorphisms, previously identified by genome-wide association studies for association with lipid levels, was analyzed for association with risk for preterm birth. The study population included 992 women in California with banked 2 nd trimester serum samples. Serum lipid levels and DNA were used. Genetic risk scores were constructed for each subject using published SNPs associated with lipid levels as an indicator of genetic burden. These genetic risk scores were then analyzed for association with risk for preterm birth. The GRS were not associated with the overall risk for preterm birth. However, a higher HDL-C GRS was associated with increased risk for spontaneous preterm birth. Higher triglyceride and total cholesterol GRS were associated with decreased risk for spontaneous preterm birth. The relationship between pre-pregnancy dyslipidemia and risk for preterm birth was assessed in a cohort of 2,962,434 women giving birth in the state of California from 2007-2012. Dyslipidemia, as defined by medical diagnostic codes, was associated with a 1.5-fold increase in risk for preterm birth. This association was consistent across race/ethnicity, body mass index, type of dyslipidemia, and type of preterm birth. This thesis identified counter-intuitive associations between lipid GRS and spontaneous preterm birth, while also identifying a strong relationship between pre-pregnancy dyslipidemia and all types of preterm birth including spontaneous. Together, these findings suggest that the previously reported associations between lipids and preterm birth may be reflecting unidentified dyslipidemias. One possible interpretation of the counter-intuitive genetic findings is that while iv extreme dyslipidemia predisposes to preterm birth a genetic predisposition to low total cholesterol also confers increased risk for spontaneous preterm birth. An alternative explanation is that these results are simply an artefact of the data and additional genetic loci and lifestyle factors confer stronger effects on risk for spontaneous PTB than the effects of the genetic loci included in this thesis. v

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Clustering of metabolic risk factors and adverse pregnancy outcomes: a prospective cohort study

Abstract: Background The relative contributions of a cluster of metabolic risk factors to pregnancy complications are not fully understood. We investigated the correlation between clustering of metabolic risk factors and adverse pregnancy outcomes.

Cited by 49 publications

References 41 publications

Are maternal metabolic syndrome and lipid profile associated with preterm delivery and preterm premature rupture of membranes?

Are maternal metabolic syndrome and lipid profile associated with preterm delivery and preterm premature rupture of membranes?

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

Genetic and metabolic associations with preterm birth

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