Combined elevated midpregnancy tumor necrosis factor alpha and hyperlipidemia in pregnancies resulting in early preterm birth

Abstract

Objective To determine whether pregnancies resulting in early preterm birth (< 30 weeks) were more likely than term pregnancies to have elevated mid-trimester tumor necrosis factor alpha (TNF-α) levels co-occurring with lipid patterns suggestive of hyperlipidemia. Study Design Patterns were examined using stored non-fasted serum samples from 108 California and 734 Iowa singleton pregnancies collected as part of statewide prenatal screening. The frequency of elevated mid-pregnancy serum TNF-α levels and lipid patterns suggestive of hyperlipidemia (e.g. elevated total cholesterol (TC), low-density-lipoproteins (LDLs), or triglycerides (TGs), decreased high-density lipoproteins (HDLs)) (considered independently and by co-occurrence) were compared in pregnancies resulting in early preterm birth to those resulting in term birth using logistic regression models. Results While no differences between preterm and term pregnancies were evident when TNF-α or target lipid abnormalities occurred in isolation, early preterm pregnancies were two to four times more likely than term pregnancies to have elevated TNF-α levels co-occurring with indicators of hyperlipidemia (37.5% versus 13.9% in the California sample (adjusted OR 4.0, 95% CI 1.1 – 16.3) and 26.3% versus 14.9% in the Iowa sample (adjusted OR 2.7, 95% CI 1.1 – 6.3)). Observed differences were not explicable to any maternal or infant characteristics. Conclusion Pregnancies resulting in early preterm birth were more likely than term pregnancies to have elevated mid-pregnancy TNF-α levels co-occurring with lipid patterns suggestive of hyperlipidemia. Patterns offer clues for further study of the signaling of early parturition in preterm birth.

Effects of maternal obesity on placental function and fetal development

“…Similarly, increased proliferation was observed in the fetal hypothalamus when exposed to high levels of IL-6 in vivo and in vitro (Kim et al 2016). Elevated maternal TNF-α is associated with obesity (Stone et al 2014, Aye et al 2014b; Atègbo et al 2006), preterm birth and hyperlipidemia (Jelliffe-Pawlowski et al 2014) and elevated TNF-α from cord blood of preterm babies has been associated with cognitive deficits at 5 years of age (von Ehrenstein et al 2012). Interestingly, 35% of children with autism also suffer from childhood obesity (Granich et al 2016), further linking the in utero environment with a predisposition for both neurodevelopmental and metabolic disorders.…”

Comportamiento de los lípidos durante la gestación y su relación con acontecimientos obstétricos desfavorables

“…Por otra parte, la hipertrigliceridemia preconcepcional puede aumentar hasta en un 60% el riesgo de parto pretérmino 50 , así como la detectada en el primero 51 o en el segundo trimestre de la gestación, aumentando el riesgos hasta 5 veces 51,52 . Asimismo, se ha señalado que una baja tasa de cambio de triglicéri-dos durante el embarazo puede ser un marcador de riesgo de parto prematuro 53,54 . Frente a todas estas evidencias,…”

“…Por otra parte, algún estudio ha relacionado niveles bajos de triglicéridos y riesgo de parto pretérmino, aunque esta asociación únicamente se establece con el parto pretérmino iatrógeno y no con el parto pretérmino espontáneo (este último se relaciona con triglicéridos elevados)46 .En un estudio de intervención con suplementos de áci-dos grasos omega-3 en mujeres con antecedentes de partos pretérmino, solo se demostró una relación entre parto pretérmino recurrente y el tamaño de partículas VLDL medido mediante resonancia nuclear magnética57 .La mayoría de estudios que evalúan la relación entre la colesterolemia y el riesgo de parto pretérmino apoyan la teoría de que los niveles tanto elevados como bajos de colesterol serían un indicador de riesgo para parto pretérmino5,46,47,49,50,[53][54][55] . De los diferentes modelos desarrollados, el que mejor detecta las gestantes con predisposición al parto pretérmino contiene como variables el colesterol total en el primer trimestre y el incremento de colesterol entre trimestres, además de otros parámetros como la alfa-fetoproteína, la inhibina y las características de la paciente44 .…”

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

“…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.…”