Maternal Lipids at Mid-pregnancy and the Risk of Preterm Delivery
Published Date:May 01 2012
Source:Acta Obstet Gynecol Scand. 91(6):726-735.
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
This study examined associations between maternal lipid levels at mid-pregnancy and preterm delivery, medically indicated or spontaneous.
Prospective cohort study.
Women were recruited from 52 clinics in five Michigan, U.S.A communities (1998–2004).
Pregnant women were enrolled at 15–27 weeks’ gestation and followed to delivery (n=3019).
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).
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).
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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