Maternal preconception lipid profile and gestational lipid changes in relation to birthweight outcomes

Bever, Alaina M.; Mumford, Sunni; Schisterman, Enrique F.; Sjaarda, Lindsey A.; Perkins, Neil J.; Gerlanc, Nicole; DeVilbiss, Elizabeth A.; Silver, Robert M.; Kim, Keewan; Nobles, Carrie J.; Amyx, Melissa; Levine, Lindsay D.; Grantz, Katherine L.

doi:10.1038/s41598-019-57373-z

Cited by 23 publications

(24 citation statements)

References 38 publications

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“…The increase in HDL was associated with decreased BW z-score in women with GDM [3]. However, Bever et al [33] found that the increase in HDL-c concentration from prepregnancy to gestational week 28 was associated with a decreased risk of SGA in the BMI ≥ 25 kg/m 2 group. This study aimed to evaluate the associations between exposure and outcomes in all participants and the models including liner and logistic regression had been adjusted for pre-BMI.…”

Section: Discussionmentioning

confidence: 93%

Associations between maternal serum HDL-c concentrations during pregnancy and neonatal birth weight: a population-based cohort study

et al. 2020

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Background: To evaluate the associations between maternal serum concentrations of high-density lipoprotein cholesterol (HDL-c) throughout pregnancy and neonatal birth weight (BW) and small for gestational age (SGA) births. Methods: A prospective cohort of 2241 pregnant women was followed from recruitment to delivery in three hospitals in Beijing, China between January 2014 and December 2017. Maternal fasting serum lipids concentrations were measured at gestational week 6-12, 16, 24 and 36. Major outcome was neonatal BW. The associations between maternal HDL-c and BW were estimated by linear regression and linear mixed-effects models. Odds ratios (ORs) and 95% confidence intervals of SGA births in relation to HDL-c were evaluated via logistic regression analysis. Results: There was a tendency that mothers with higher HDL-c concentrations throughout gestation gave birth to infants with lower BW. A negative association was found between maternal HDL-c concentrations and BW at 24th and 36th gestational weeks (B = − 34.044, P = 0.034; B = − 53.528, P = 0.000). The HDL-c trend of change was inversely associated with BW (B = − 442.736, P = 0.000). Mothers with SGA neonates had higher serum HDL-c concentration at the 36th gestational week (P < 0.01). The incidences of SGA in the three groups (HDL-c: 1.84-2.23 mmol/L, 2.24-2.59 mmol/L and ≥ 2.60 mmol/L) were higher than the group with the lowest concentration of HDL-c (< 1.83 mmol/L) (P < 0.01, P < 0.01, P < 0.001) at 36th week. Higher maternal HDL-c concentrations at 36th week (HDL-c: 1.84-2.23 mmol/L, 2.24-2.59 mmol/L and ≥ 2.60 mmol/L) were positively associated with the incidence of SGA (OR = 1.900, P = 0.008; OR = 1.893, P = 0.008; OR = 1.975, P = 0.004). The HDL-c trend of change was positively associated with SGA births (OR = 9.772, P = 0.000). Conclusions: Maternal serum HDL-c concentrations were inversely associated with BW at 24th and 36th gestational weeks. The high concentrations of HDL-c at the 36th gestational week increased the risk of SGA. The maternal HDL-c trend of change across pregnancy was associated with smaller neonatal size.

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Section: Discussionmentioning

confidence: 93%

Associations between maternal serum HDL-c concentrations during pregnancy and neonatal birth weight: a population-based cohort study

et al. 2020

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“…HDL-c, as a protective factor for vascular endothelial cells, plays a vital role in protecting the cardiovascular system of pregnant women during pregnancy [16]. This may indicate that relatively higher levels of maternal HDL-c are associated with a reduced risk of SGA, which could be demonstrated by Bever et al [20]. However, our nding regarding the association between the levels of maternal HDL-c and SGA seemed to be a little counterintuitive.…”

Section: Discussionmentioning

confidence: 75%

“…On the one hand, elevated maternal HDL-c has vasodilatory, antioxidant, antithrombotic and anti-in ammatory effects in protecting against endothelial cell damage during pregnancy [16]. This anti-in ammatory effect is helpful to reduce the risk of PTB, which could be demonstrated in a recent systematic review [17].On the other hand, maternal elevated HDL-c has an important effect on promoting foetal growth and development [18] and reduces the risk of low birth weight [19] and SGA [20]. However, a systematic review found that the risk of PTB was not affected by HDL-c [21].…”

Section: Introductionmentioning

confidence: 99%

Maternal HDL-c levels are associated with preterm birth and small for gestational age: A prospective study in China

Chen

Feng

Yang

et al. 2022

Preprint

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Background: Evidence suggests that maternal HDL-c levels are associated with preterm birth (PTB) and small for gestational age (SGA). However, existing evidence remains controversial. We aimed to explore the associations of maternal HDL-c levels with PTB and SGA in China.Method: A prospective study that included 1068 pregnant women was conducted in 2017. The concentrations of high-density lipoprotein cholesterol (HDL-c) were analyzed in early, middle, and late pregnancy as continuous variables and categorical variables (by percentile groups). Data on gestational age, as well as the weight and length of the neonates were recorded after delivery. Multivariable logistic regression models were used to estimate the associations between maternal HDL-c levels and PTB and SGA. Result:PTB and SGA occurred in 3.0% and 8.1% of births. Mean maternal HDL-c levels in early pregnancy was equal to that in middle pregnancy (1.67 vs. 1.66 mmol/L, p = 0.309), but decreased slightly from middle pregnancy to late pregnancy (1.66 vs. 1.52mmol/L, p < 0.001). In middle pregnancy, every unit elevation of HDL-c was positively associated with SGA (OR = 2.57, 95 % CI: 1.23-5.35). In late pregnancy, every unit elevation of HDL-c reduced the risk of PTB (OR = 0.12, 95 % CI: 0.03-0.58), but increased the risk of SGA (OR = 2.59, 95 % CI: 1.22-5.47). In early pregnancy, low (<25th percentile) HDL-c was positively associated with PTB (OR = 2.56, 95 % CI: 1.11-5.09), and high (>75th percentile) HDL-c was positively associated with SGA (OR = 2.92, 95 % CI: 1.69-5.04), compared with referent (25th-75th percentile) HDL-c.Conclusion:Maternal high levels of HDL-c could reduce the risk of PTB but increase the risk of SGA. There may exist appropriate reference range for maternal HDL-c in early pregnancy. Maternal HDL-c levels should be monitored regularly during pregnancy to decrease adverse perinatal outcomes.

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“…We only had information on maternal biomarker characteristics available from non-fasting samples in the first half of pregnancy. Previous studies have shown that maternal early-pregnancy biomarkers at least partly reflect maternal biomarkers in the preconception period [ 37 , 38 ]. However, to enable use of the full model already before pregnancy and in earlier stages of pregnancy, further studies are needed to replicate findings using maternal biomarker characteristics already obtained prior or in earlier stages of pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Preconception and early-pregnancy risk prediction for birth complications: development of prediction models within a population-based prospective cohort

Wahab

Jaddoe

Klaveren

et al. 2022

BMC Pregnancy Childbirth

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Background Suboptimal maternal health already from preconception onwards is strongly linked to an increased risk of birth complications. To enable identification of women at risk of birth complications, we aimed to develop a prediction model for birth complications using maternal preconception socio-demographic, lifestyle, medical history and early-pregnancy clinical characteristics in a general population. Methods In a population-based prospective cohort study among 8340 women, we obtained information on 33 maternal characteristics at study enrolment in early-pregnancy. These characteristics covered the preconception period and first half of pregnancy (< 21 weeks gestation). Preterm birth was < 37 weeks gestation. Small-for-gestational-age (SGA) and large-for-gestational-age (LGA) at birth were gestational-age-adjusted birthweight in the lowest or highest decile, respectively. Because of their co-occurrence, preterm birth and SGA were combined into a composite outcome. Results The basic preconception model included easy obtainable maternal characteristics in the preconception period including age, ethnicity, parity, body mass index and smoking. This basic preconception model had an area under the receiver operating characteristics curve (AUC) of 0.63 (95% confidence interval (CI) 0.61 to 0.65) and 0.64 (95% CI 0.62 to 0.66) for preterm birth/SGA and LGA, respectively. Further extension to more complex models by adding maternal socio-demographic, lifestyle, medical history and early-pregnancy clinical characteristics led to small, statistically significant improved models. The full model for prediction of preterm birth/SGA had an AUC 0.66 (95% CI 0.64 to 0.67) with a sensitivity of 22% at a 90% specificity. The full model for prediction of LGA had an AUC of 0.67 (95% CI 0.65 to 0.69) with sensitivity of 28% at a 90% specificity. The developed models had a reasonable level of calibration within highly different socio-economic subsets of our population and predictive performance for various secondary maternal, delivery and neonatal complications was better than for primary outcomes. Conclusions Prediction of birth complications is limited when using maternal preconception and early-pregnancy characteristics, which can easily be obtained in clinical practice. Further improvement of the developed models and subsequent external validation is needed.

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Maternal preconception lipid profile and gestational lipid changes in relation to birthweight outcomes

Cited by 23 publications

References 38 publications

Associations between maternal serum HDL-c concentrations during pregnancy and neonatal birth weight: a population-based cohort study

Associations between maternal serum HDL-c concentrations during pregnancy and neonatal birth weight: a population-based cohort study

Maternal HDL-c levels are associated with preterm birth and small for gestational age: A prospective study in China

Preconception and early-pregnancy risk prediction for birth complications: development of prediction models within a population-based prospective cohort

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