Maternal lipid levels in early pregnancy as a predictor of childhood lipid levels: a prospective cohort study

Abstract

Background Maternal lipid levels in early pregnancy are associated with maternal health and foetal growth. It is however unclear if maternal lipids in early pregnancy can be used to predict childhood lipid levels. The aim of this study is to assess the association between maternal and offspring childhood lipid levels, and to investigate the influence of maternal BMI and diet on these associations. Methods This study included 2692 women participating in the Generation R study, an ongoing population-based prospective cohort study from early life onwards. Women with an expected delivery date between 2002 and 2006 living in Rotterdam, the Netherlands were included. Total cholesterol, triglycerides and high-density lipoprotein cholesterol (HDL-c) were measured in early pregnancy (median 13.2 weeks [90% range 10.6; 17.1]). Low-density lipoprotein cholesterol (LDL-c), remnant cholesterol and non-HDL-c were calculated. Corresponding lipid measurements were determined in 2692 children at the age of 6 (median 6.0 years [90% range 5.7; 7.5]) and 1673 children 10 years (median 9.7 years [90% range 9.5; 10.3]). Multivariate linear regression analysis was used to examine the association between maternal lipid levels in early pregnancy and the corresponding childhood lipid measurements at the ages of 6 and 10 years while adjusting for confounders. Results Maternal lipid levels in early pregnancy are positively associated with corresponding childhood lipid levels 6 and 10 years after pregnancy, independent of maternal body mass index and diet. Conclusions Maternal lipid levels in early pregnancy may provide an insight to the lipid profile of children years later. Gestational lipid levels may therefore be used as an early predictor of children’s long-term health. Monitoring of these gestational lipid levels may give a window-of-opportunity to start early interventions to decrease offspring’s lipid levels and possibly diminish their cardiovascular risk later in life. Future studies are warranted to investigate the genetic contribution on maternal lipid levels in pregnancy and lipid levels of their offspring years later.

Significance of lipids, lipoproteins, and apolipoproteins during the first 14–16 months of life

“…In this study, we found significantly higher concentrations of total cholesterol, LDL cholesterol, HDL cholesterol, non-HDL cholesterol, and apolipoprotein B in girls compared to boys. These findings are in agreement with previous findings for total cholesterol, LDL cholesterol, and HDL cholesterol, 12 , 23–26 but have not been shown for non-HDL and apolipoprotein B previously. However, in this study, we observed lower mean and median concentrations of total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides in umbilical cord blood compared to concentrations reported in previous studies, 23–25 which may be due to differences in ethnicities, and lower number of individuals (ranging from 206 to 442) in the previous studies of Iranian and Polish origin.…”

“… 11 Maternal lipid concentrations in early pregnancy have been shown to associate with offspring venous blood concentrations in later childhood (age 6 and 10 years). 12 Dyslipidaemia in childhood and adolescence is associated with dyslipidaemia in adulthood, fatty streaks in the aorta, and increased intima-media thickness 13–17 with FH as the classical example for ASCVD development in early adulthood. 18 However, if lifestyle interventions and treatments are initiated during childhood, the risk of ASCVD can be minimized and become similar to the background population—observations that emphasize the importance of early interventions.…”

Lipid metabolism during pregnancy: consequences for mother and child

“…Results from this same cohort further showed that maternal early gestational lipid profile is associated with offspring's lipid profile at age 5–6 years [6]. Similar to findings from a Norwegian study in 61 mother-children pairs [42], in the ongoing population-based Generation R study, lipid profile in early pregnancy ( n = 2692, median 13.2 weeks) was associated with the lipid profile of children at 6 and 10 years after pregnancy [43 ▪▪ ], independent of maternal BMI and diet.…”

Maternal prenatal cholesterol levels predict offspring weight trajectories during childhood in the Norwegian Mother, Father and Child Cohort Study

“…We have previously found a positive association between maternal prenatal HDL-C and newborn HDL-C level [ 34 ]. Hence, maternal mid-pregnancy TC and HDL-C levels probably affect fetal TC and HDL-C levels but also possibly offspring TC and HDL-C later in childhood [ 48 , 49 ]. High offspring LDL-C level may increase and high offspring HDL-C level may decrease the supply of cholesterol to peripheral cells [ 50 ], which in theory may affect the offspring’s development or epigenetic pattern, and subsequent body growth [ 5 , 20 – 22 ].…”