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. 2022 Aug 15;22(1):642.
doi: 10.1186/s12884-022-04960-0.

Consecutive reference intervals for biochemical indices related to serum lipid levels and renal function during normal pregnancy

Lina Wu  1   2 , Qijun Wu  3 , Qiang Li  1   2 , Shuang Cao  1   2 , Yue Zhang  1   2 , Yong Liu  1   2 , Xiaosong Qin  4   5
Affiliations

Consecutive reference intervals for biochemical indices related to serum lipid levels and renal function during normal pregnancy

Lina Wu et al. BMC Pregnancy Childbirth. .

Abstract

Background: Physiological changes that occur during pregnancy can influence serum lipid levels and laboratory tests for renal function. Therefore, we established consecutive and reliable RIs for serum lipid and renal function indices for pregnant women in China throughout the entirety of pregnancy.

Methods: We included 120 healthy pregnant women who underwent a naturally conceived and uncomplicated pregnancy and delivered a healthy singleton neonate. Serum samples were collected at ten time points (pre-pregnancy, gestational age ≤ 8 weeks (W), 8 W+1 to 12 W, 12 W+1 to 16 W, 16 W+1 to 20 W, 20 W+1 to 24 W, 24 W+1 to 28 W, 28 W+1 to 32 W, 32 W+1 to 36 W, and 36 W+1 to 40 W) and analyzed for ten common serum lipid and renal function analytes. RIs were calculated according to the International Federation of Clinical Chemistry and Laboratory Medicine recommendations and compared with the established RIs for healthy adult women.

Results: During pregnancy, we observed significant increases in total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), apolipoprotein-A1 (Apo-A1), apolipoprotein-B (Apo-B), cystatin C (Cys-C), and estimated glomerular filtration rate (eGFR). We also observed clear reductions in urea, creatinine (Crea), and uric acid (UA). Compared with the previously established RIs, the most significant misclassifications were recorded for TG, Apo-A1, Crea, and eGFR.

Conclusions: We successfully described key changes in serum lipid levels and renal function indices throughout pregnancy. It is important to establish RIs for blood indices in women undergoing normal pregnancies during different period of pregnancy to avoid the misdiagnosis of disease states.

Keywords: Biochemical indices; Pregnancy; Reference interval; Renal function; Serum lipid.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of the selection of participants
Fig. 2
Fig. 2
Distributions and changes of serum lipid levels. The ranges between the two dotted lines represent non-pregnant normal reference interval. Apo-A1, apolipoprotein-A1, Apo-B, apolipoprotein-B, G0: pre-pregnancy, G1: ≤ 8 W, G2: 8 W+1-12 W, G3: 12 W+1-16 W, G4: 16 W+1-20 W, G5: 20 W+1-24 W, G6: 24 W+1-28 W, G7: 28 W+1-32 W, G8: 32 W+1-36 W, G9: 36 W+1-40 W, HDL-C: high density lipoprotein cholesterol, LDL-C: low density lipoprotein cholesterol, TC: total cholesterol, TG: triglycerides
Fig. 3
Fig. 3
Distributions and changes of renal function indexes. The ranges between the two dotted lines represent non-pregnant normal reference interval. Crea: creatinine, Cys-C: cystatin C, eGFR: estimated glomerular filtration rate, G0: pre-pregnancy, G1: ≤ 8 W, G2: 8 W+1-12 W, G3: 12 W+1-16 W, G4: 16 W+1-20 W, G5: 20 W+1-24 W, G6: 24 W+1-28 W, G7: 28 W+1-32 W, G8: 32 W+1-36 W, G9: 36 W+1-40 W, UA: uric acid
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