Maternal Lipid Change in Relation to Length of Gestation: A Prospective Cohort Study with Preconception Enrollment of Women

Abstract

Background/Aims: We sought to investigate the association between preconception serum lipids and their daily rate of change in relation to length of gestation. Methods: In a cohort of 70 women, 61 (87%) became pregnant, resulting in 48 (69%) live births. Serum lipid measurements (in milligrams per deciliter) included total cholesterol, free cholesterol, triglycerides and phospholipids at preconception, upon human chorionic gonadotropin-confirmed pregnancy and following pregnancy loss (<14 weeks) or post partum. Pregnancy outcome (loss, preterm and term delivery) and gestational length were modeled relative to daily rate of change in lipids using multinomial regression and Cox proportional hazards models, respectively, adjusting for body mass index and smoking. Results: A rate of triglyceride change below the median was associated with an increased risk for pregnancy loss compared with term birth (adjusted odds ratio: 9.02; 95% CI: 1.62-50.30). A rate of triglyceride change of ≤0.01 mg/dl per day versus above the median was associated with a trend for increased risk of pregnancy loss or preterm (<37 weeks) birth (adjusted hazard ratio: 1.77; 95% CI: 0.94-3.33). Conclusion: A low rate of triglyceride change during early pregnancy may be a signal of risk of pregnancy loss or preterm birth. Lipids offer promise for identifying pregnancies at risk for adverse outcomes.

1H NMR-based metabolomics study on the physiological variations during the rat pregnancy process

“…Among the reported changes, those in amino acid metabolism, energy and gut microflora metabolisms were observed in connection to pregnancy (Pinto et al, 2015). These metabolic changes of pregnancy directly influence the health conditions of the mother and the development of the fetus (Laughon et al, 2014). However, the reasons for these changes in metabolic process relating to the metabolism of pregnant mother are still not well understood.…”

“…Moreover, protein and nitrogen metabolism were found to play extremely important roles in pregnancy and the development of the fetus (Altobelli et al, 2013). The conservation and accretion of nitrogen in mother and fetal bodies, for example, fat accumulation and lipogenesis, were started in early pregnancy (Altobelli et al, 2013;Laughon et al, 2014). In addition, carbohydrate metabolism received particular concerns due to the wellrecognized clinical disorder known as diabetes mellitus (Hernandez et al, 2014).…”

Effect of Histone Deacetylase HDAC3 on Cytokines IL-18, IL-12 and TNF-α in Patients with Intrahepatic Cholestasis of Pregnancy

“…The molecular mechanism of the pathophysiology of ICP remains unknown [2, 17]. It has been demonstrated that epigenetics may play a role in the development of ICP.…”

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 .…”