Evaluating fetal cord blood lipids and oxidized LDL status in intrauterine growth restriction and preeclampsia

Ziel: Intrauterine growth restriction (IUGR) and preeclampsia (PE) affect 3–8% of pregnancies. Theunderlying causes are not fully understood. Maternal metabolic changes contribute to the pathogenesisin both, PE and IUGR. Whether a disturbed lipid metabolism and cholesterol supply affect the fetus withconsequences for fetal programming of cardiovascular diseases later in life remains to be clarified. Wehere evaluated fetal chord blood lipids in IUGR and PE and hypothesized a more atherogeniclipoprotein profile in IUGR fetuses.

Methodik: Umbilical cord serum TC, LDL-C, HDL-C, and oxLDL concentrations of IUGR (n=28), IUGR withconcomitant PE (IUGR+PE, n=8), PE without IUGR (PE, n=14), and constitutional small for gestational ageneonates (cSGA, n=22) were compared to those of healthy adequate for gestational age born neonates(CN, n=97). Statistical estimations were performed using ANCOVA thereby adjusting for gestational ageat delivery.

Ergebnis: Fetal HDL-C- and TC-concentrations were found to be significantly lower in the IUGR and IUGR+PE groups when compared to CN, cSGA, and PE (HDL-C: p < 0.001, TC: p < 0.01). Atherogenic indicesincluding oxLDL/LDL-C ratio were significantly increased in IUGR compared to CN (oxLDL/LDL-C ratio.p < 0.001).

Schlussfolgerung: Our results support the hypothesis of a disturbed cholesterol supply in IUGR fetuses. Bornsmall for gestational age has been shown to be a risk factor for developing cardiovascular disease laterin life. Since HDL-C has anti-inflammatory properties a reduced HDL-C during fetal development and anincrease in atherogenic indices might provide a link to this observation in IUGR fetuses.

IUGR - fetal cord blood lipids - oxidative stress - preeclampsia