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Maternal Lipids at Mid-pregnancy and the Risk of Preterm Delivery
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6 2012
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Source: Acta Obstet Gynecol Scand. 91(6):726-735
[PDF-1.03 MB]
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Alternative Title:Acta Obstet Gynecol Scand
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Description:Objective
This study examined associations between maternal lipid levels at mid-pregnancy and preterm delivery, medically indicated or spontaneous.
Design
Prospective cohort study.
Setting
Women were recruited from 52 clinics in five Michigan, U.S.A communities (1998–2004).
Population
Pregnant women were enrolled at 15–27 weeks’ gestation and followed to delivery (n=3019).
Methods
A single blood sample was obtained at study enrollment. Blood lipids, i.e., total (TC), high-density lipoprotein (HDLc), low-density lipoprotein (LDLc) cholesterol, and triglycerides (TG), were measured on a subcohort (n=1,309).
Main Outcome Measures
There were 221 spontaneous, 100 medically indicated preterm deliveries and 988 term deliveries. Polytomous logistic regression models examined relations among cholesterol levels (Low: <10th %tile, Referent: 10th–<70th %tile, High: ≥70th %tile), quartiles of TG (Referent: first quartile) and delivery outcome (Referent: term).
Results
Odds of medically indicated preterm delivery were increased among women with low TC (adjusted odds ratio (aOR)= 2.04, 95% confidence interval (CI): 1.12,3.72), low HDLc (aOR=1.89, 95%CI: 1.04,3.42), or low LDLc (aOR=1.96, 95%CI: 1.09,3.54). Odds of spontaneous preterm delivery were increased among women with high TC (aOR=1.51, 95%CI: 1.06,2.15), high LDLc (aOR=1.42, 95%CI: 0.99,2.04) or high TG (aOR=1.90, 95%CI: 1.21,2.97 and aOR=1.72, 95%CI: 1.06,2.78 for third and fourth quartiles, respectively).
Conclusions
Extremely low TC, HDLc and LDLc were associated with a modest increase in risk of medically indicated preterm delivery, while high TC, LDLc and TG modestly increased risk of spontaneous preterm delivery. Further research is needed to uncover explanations for these associations and to identify optimal ranges for maternal lipids.
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Source:
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Pubmed ID:22404756
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Pubmed Central ID:PMC4563824
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