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Maternal Lipids at Mid-pregnancy and the Risk of Preterm Delivery
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Details:
  • Pubmed ID:
    22404756
  • Pubmed Central ID:
    PMC4563824
  • Funding:
    R01 HD034543/HD/NICHD NIH HHS/United States
    R01 HD34543/HD/NICHD NIH HHS/United States
    U01 DP000143-01/DP/NCCDPHP CDC HHS/United States
  • Document Type:
  • Collection(s):
  • 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.