Association between maternal blood lipids levels during pregnancy and risk of small-for-gestational-age infants

Abstract

Dyslipidemia in pregnancy are associated with risk of adverse outcomes. As an adverse pregnancy outcome, small-for-gestational-age has been extensively studied in Western countries. However, similar studies have rarely been conducted in Asian countries. Data were derived from 5695 pairs of non-diabetic mothers and neonates between 1 Jan 2014 and 31 Dec 2014. 5.6% neonates in our study were SGA. Serum samples were collected during second and third trimesters for evaluation on fasting lipids levels. The present study intended to explore the associations between maternal lipid profile and small-for-gestational-age neonates. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated and adjusted via logistic regression analysis. After adjustments for confounders, third-trimester total cholesterol levels were associated with a decreased risk for small-for-gestational-age (aOR = 0.622, 95% CI 0.458-0.848, P = 0.002), and third-trimester high-density lipoprotein cholesterol and low-density lipoprotein cholesterol levels were associated with an increased risk for small-for-gestational-age (aOR = 1.955, 95% CI 1.465-2.578, P < 0.001; aOR = 1.403, 95% CI 1.014-1.944, P = 0.041).In the highest gestational weight gain strata, especially the third-trimester, the effect of high-density lipoprotein cholesterol levels on the risk for small-for-gestational-age is larger. High high-density lipoprotein cholesterol level during third trimester could be considered as indicators of a high-risk of small-for-gestational-age, regardless of gestational weight gain.

Figure 1

Flow diagram of study inclusion and exclusion process. In total, 14,735 patients were recruited in Women’s Hospital, Zhejiang University School of Medicine in 2014. Among them, 14,660 participants had complete data on lipid measurements and other covariates. We excluded 18 women who are young (< 19 years) or in elder age (> 44 years), 24 women who had diabetes mellitus, malignant tumor, inherited metabolic diseases before pregnancy, or experienced serious infection during early pregnancy, and 3430 women pregnancy complications such as gestational diabetes mellitus (GDM), pregnancy-induced hypertension (PIH), preeclampsia (PE) and intrahepatic cholestasis of pregnancy (ICP). We additionally excluded 3672 women who used tobacco, consumed alcohol or took anti-hyperlipidemic medication during pregnancy. After excluding newborn characteristics (not singleton, stillbirth, 5-min-postpartum Apgar scores < 7, premature or post-term delivery, or newborns with chromosomal abnormalities, inherited metabolic diseases and congenital abnormalities), the final analytic sample of 5695 participants was obtained.