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Am J Perinatol 2021; 38(08): 834-840
DOI: 10.1055/s-0039-3402724
Original Article

Associations between Maternal Lipid Profiles and Pregnancy Complications: A Prospective Population-Based Study

Yiqi Zhang
1   Department of Nutrition, Food Safety and Toxicology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
,
Xi Lan
1   Department of Nutrition, Food Safety and Toxicology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
,
Congjie Cai
1   Department of Nutrition, Food Safety and Toxicology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
,
Run Li
2   Department of Clinical Nutrition, Sichuan Provincial Hospital for Women and Children, Chengdu, Sichuan, China
,
Yan Gao
3   Department of Obstetrics, Sichuan Provincial Hospital for Women and Children, Chengdu, Sichuan, China
,
Liuqing Yang
1   Department of Nutrition, Food Safety and Toxicology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
,
Cheng Wu
1   Department of Nutrition, Food Safety and Toxicology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
,
Hongli Dong
1   Department of Nutrition, Food Safety and Toxicology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
,
Xinxin Pang
1   Department of Nutrition, Food Safety and Toxicology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
,
Dan Bai
1   Department of Nutrition, Food Safety and Toxicology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
,
Guo Zeng
1   Department of Nutrition, Food Safety and Toxicology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
› Author Affiliations Funding This project was funded by Danone Nutrition Center Dietary Nutrition Research and Education Fund (DIC2016–06).
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Abstract

Objective To investigate whether plasma lipid profiles are independently associated with pregnancy complications including gestational diabetes mellitus (GDM), hypertensive disorder complicating pregnancy (HDCP), and intrahepatic cholestasis of pregnancy (ICP).

Study Design A prospective study was conducted among 1,704 pregnant women at three medical institutions in Chengdu, China. The concentrations of triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were measured at gestational weeks 12 ± 1, 24 ± 1, and 34 ± 1. Logistic regression models were used to estimate the association between lipid profiles and pregnancy complications. Receiver operating characteristic analysis was performed to determine the value of lipid profiles to predict GDM and HDCP.

Results After adjusting for potential confounders, TG, TC, and LDL-C in the first trimester were independently associated with GDM (TG: odds ratio [OR] =2.00, 95% confidence interval [CI]: 1.57–2.56; TC: OR = 1.38, 95% CI: 1.16–1.64; LDL-C: OR = 1.43, 95% CI: 1.14–1.79) and HDCP (TG: OR = 2.42, 95% CI: 1.56–3.78, TC: OR = 1.64, 95% CI: 1.04–2.57; LDL-C: OR = 1.87, 95% CI: 1.07–3.25). The TC concentration during the whole pregnancy (first trimester: OR = 1.53, 95% CI: 1.13–2.08; second trimester: OR = 1.31, 95% CI: 1.06–1.61; third trimester: OR = 1.39, 95% CI: 1.17–2.04) and LDL-C in the last two trimesters (second trimester: OR = 1.62, 95% CI: 1.30–2.04; third trimester: OR = 1.56, 95% CI: 1.29–1.88) were positively associated with ICP. HDL-C in the third trimester was negatively associated with the risk of ICP (OR = 0.46, 95% CI: 0.22–0.98). Combining lipid profiles in the first trimester with the other common predictors to predict GDM or HDCP owned stronger predictive power with the largest area under the curve (GDM: 0.643 [95% CI: 0.613–0.673], HDCP: 0.707 [95% CI: 0.610–0.804]) than either indicator alone.

Conclusion Maternal lipid profiles during the whole pregnancy are significantly associated with GDM, HDCP, and ICP. Combining lipid profiles in the first trimester with the other common predictors could effectively improve the power of predicting GDM and HDCP.

Keywords

lipid profile - gestational diabetes mellitus - hypertensive disorder complicating pregnancy - intrahepatic cholestasis of pregnancy


Publication History

Received: 29 August 2019

Accepted: 27 November 2019

Article published online:
31 December 2019

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