Epidemiological analysis of maternal lipid levels during the second trimester in pregnancy and the risk of adverse pregnancy outcome adjusted by pregnancy BMI

Yue, Chaoyan; Ying, Chunmei

doi:10.1002/jcla.22568

Cited by 14 publications

(13 citation statements)

References 31 publications

(82 reference statements)

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“…The results of our study showed that high concentrations of TG during the whole pregnancy are related to a high risk of GDM and HDCP, which was consistent with most previous studies. 29,30 Furthermore, we found that high maternal TC and LDL-C concentrations in the first trimester were significantly associated with an increased risk of GDM and HDCP, and the HDL-C concentration in the second trimester was negatively associated with risk for GDM. These are novel discoveries of this study, suggesting that complex metabolic disorders of maternal lipids are potentially important factors that are involved in the pathological processes of pregnancy complications, but the exact mechanism still requires further exploration.…”

Section: Discussionmentioning

confidence: 79%

Associations between Maternal Lipid Profiles and Pregnancy Complications: A Prospective Population-Based Study

et al. 2019

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Objective To investigate whether plasma lipid profiles are independently associated with pregnancy complications including gestational diabetes mellitus (GDM), hypertensive disorder complicating pregnancy (HDCP), and intrahepatic cholestasis of pregnancy (ICP). Study Design A prospective study was conducted among 1,704 pregnant women at three medical institutions in Chengdu, China. The concentrations of triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were measured at gestational weeks 12 ± 1, 24 ± 1, and 34 ± 1. Logistic regression models were used to estimate the association between lipid profiles and pregnancy complications. Receiver operating characteristic analysis was performed to determine the value of lipid profiles to predict GDM and HDCP. Results After adjusting for potential confounders, TG, TC, and LDL-C in the first trimester were independently associated with GDM (TG: odds ratio [OR] =2.00, 95% confidence interval [CI]: 1.57–2.56; TC: OR = 1.38, 95% CI: 1.16–1.64; LDL-C: OR = 1.43, 95% CI: 1.14–1.79) and HDCP (TG: OR = 2.42, 95% CI: 1.56–3.78, TC: OR = 1.64, 95% CI: 1.04–2.57; LDL-C: OR = 1.87, 95% CI: 1.07–3.25). The TC concentration during the whole pregnancy (first trimester: OR = 1.53, 95% CI: 1.13–2.08; second trimester: OR = 1.31, 95% CI: 1.06–1.61; third trimester: OR = 1.39, 95% CI: 1.17–2.04) and LDL-C in the last two trimesters (second trimester: OR = 1.62, 95% CI: 1.30–2.04; third trimester: OR = 1.56, 95% CI: 1.29–1.88) were positively associated with ICP. HDL-C in the third trimester was negatively associated with the risk of ICP (OR = 0.46, 95% CI: 0.22–0.98). Combining lipid profiles in the first trimester with the other common predictors to predict GDM or HDCP owned stronger predictive power with the largest area under the curve (GDM: 0.643 [95% CI: 0.613–0.673], HDCP: 0.707 [95% CI: 0.610–0.804]) than either indicator alone. Conclusion Maternal lipid profiles during the whole pregnancy are significantly associated with GDM, HDCP, and ICP. Combining lipid profiles in the first trimester with the other common predictors could effectively improve the power of predicting GDM and HDCP.

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Section: Discussionmentioning

confidence: 79%

Associations between Maternal Lipid Profiles and Pregnancy Complications: A Prospective Population-Based Study

et al. 2019

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“…Yue et al. found that women with higher serum TG levels (upper quartile) at 20–24 gestational weeks had 2.99‐fold risk of GDM as compared to those with lower quartile TG levels 23 . A similar association between TG in the second trimester and GDM was also observed in our study, with a higher cut‐off TG value in the second trimester (1.525 mmol/L) than in the first trimester (1.235 mmol/L).…”

Section: Discussionmentioning

confidence: 99%

“…Our results were consistent with such findings. 23 A potential mechanism underlying this phenomenon might be that patients at risk of GDM usually associate with higher levels of insulin resistance (IR), 24 whereby elevated plasma insulin concentrations would enhance very-low-density lipoprotein synthesis, 25 and lead to the increase in serum TG levels. Although TG, HDL-C, and TG/HDL-C have been reported to be associated with elevated insulin levels, TG might be the most sensitive lipid index to IR.…”

Section: The Association Between Serum Lipid Concentrations and Gdm Inmentioning

confidence: 99%

“…Obesity has been identified as a risk factor for GDM. 2,3,6 A retrospective study of 774 pregnant women in northern China showed that pre-pregnancy obesity and overweight may increase the risk of developing GDM in early pregnancy (OR = 1.52, p < 0.001) 23 . Notably, BMI in our study was calculated based on the measured body weight, which is more accurate than self-reported pre-pregnancy BMI commonly adopted in previous studies.…”

Section: The Association Between Serum Lipid Concentrations and Gdm Inmentioning

confidence: 99%

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Elevated serum triglyceride levels at first prenatal visit is associated with the development of gestational diabetes mellitus

Niu

et al. 2021

Diabetes Metabolism Res

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Aims: While several studies have indicated that maternal serum lipid profiles are associated with the development of gestational diabetes mellitus (GDM), the results have been inconsistent. This study aimed to explore the relationship between maternal lipids profiles at first prenatal visit and GDM and determine the optimal cut-off values of possible trimester-specific variables in predicting GDM. Materials and Methods:Clinical data of women with singleton pregnancies who delivered in Xinhua Hospital between January 2016 and January 2017 were collected from electronic databases. Multivariate logistic regression was used to determine the potential risk factors of GDM (specific to the trimester at first prenatal visit), including age, body mass index (BMI), and serum lipid profile and fasting plasma glucose (FPG) levels. The receiver operating characteristic (ROC) curve analysis was performed to determine the cut-off values of significant variables.Results: Among the 2191 pregnant women included, 315 (14.38%) were diagnosed with GDM. Of these, 880 (40.16%) had their first prenatal visit before 14 gestational weeks. Univariate and multivariate analyses showed that both FPG and triglyceride (TG) levels in the first and second trimesters were associated with a high risk of GDM (p < 0.05). The ROC curve showed that serum TG levels >1.235 mmol/ L and >1.525 mmol/L in the first and second trimesters, respectively, were significantly associated with the development of GDM (p < 0.05).

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“…Although maternal hyperlipidaemia represents a physiological state during pregnancy, malfunction in the mechanisms regulating lipid metabolic profiles may lead to adverse outcomes [ 2 , 7 ]. Disturbances in maternal lipid metabolism have been shown to increase the risks of pregnancy complications and adverse perinatal outcomes such as preeclampsia (PE), gestational diabetes mellitus (GDM), preterm birth and foetal growth disorders [ 8 , 9 ].…”

Section: Introductionmentioning

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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Epidemiological analysis of maternal lipid levels during the second trimester in pregnancy and the risk of adverse pregnancy outcome adjusted by pregnancy BMI

Abstract: Abnormal blood lipid levels in pregnancy are significantly associated with GDM, pre-eclampsia, and other adverse pregnancy outcomes.

Cited by 14 publications

References 31 publications

Associations between Maternal Lipid Profiles and Pregnancy Complications: A Prospective Population-Based Study

Associations between Maternal Lipid Profiles and Pregnancy Complications: A Prospective Population-Based Study

Elevated serum triglyceride levels at first prenatal visit is associated with the development of gestational diabetes mellitus

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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