The associations between early pregnancy lipid profiles and pregnancy outcomes

Objective:to evaluate the association between early pregnancy lipid profiles and pregnancy outcomes.study design:retrospective 6 months analysis of 5218 singleton pregnant women. each participant’s demographic and medical data were collected by questionnaires and medical records. total cholesterol (tc), triglycerides (tg), high-density lipid cholesterol (hdl-c) and low-density lipid cholesterol (ldl-c) levels were divided into quartiles, and the women were categorized as having low (<25th percentile), referent (25 to <75th percentile) or high (>75th percentile) tc, tg, hdl-c and ldl-c values. differences between groups were tested using t-test and pearson's χ2-test. binary logistic regression and multivariate analysis was conducted to evaluate the associations between lipid values and the risk of pregnancy outcomes.results:(1) women who subsequently developed adverse pregnancy outcomes had higher levels of tc, tg, ldl-c and lower levels of hdl-c during early pregnancy (<14 gestational weeks). (2) a trend toward an increasing incidence of adverse pregnancy outcomes was noted with increasing levels of tc, tg and ldl-c, and decreasing level of hdl-c. (3) the more numbers of tc, tg and ldl-c above 75th percentile and hdl-c inferior to 25th percentile women had, the higher their risk of developing adverse pregnancy outcomes. (4) low tg level was a protective factor for gestational diabetes mellitus (gdm) (<1.44 mmol l−1, odds ratio (or)=0.706, 95% confidence interval (ci), 0.586 to 0.852) and large for gestational age infants (lga) (<1.44 mmol l−1, or=0.769, 95% ci, 0.631 to 0.936), and low ldl-c (<1.89 mmol l−1) level was protective factor for preterm birth. high tg (>1.40 mmol l−1, or=1.327, 95% ci, 1.130 to 1.558), tc (>4.29 mmol l−1, or=1.250, 95% ci, 1.062 to 1.471), and ldl-c (>2.62 mmol l−1, or=1.25, 95% ci, 1.069 to 1.480) levels and a low hdl-c (<1.89 mmol l−1, or=1.190, 95% ci, 1.007 to 1.405) level were associated with increased risk of gdm. a high tg (>1.40 mmol l−1, or=1.550, 95% ci, 1.025 to 2.343) level was related to high risk of pre-eclampsia (pe), while a high ldl-c (>2.62 mmol l−1, or=1.400, 95% ci, 1.100 to 1.781) level was risk factor for macrosomia. (5) after adjusting for confounders, early pregnancy tc was an independent risk factor for gdm (ajusted odds ratio [aor]=1.184, 95% ci, 1.085 to 1.291), tg level was independently associated with the prevalence of gdm (aor=1.253, 95% ci, 1.141 to 1.375) and pe (aor=1.245, 95% ci, 1.023 to 1.516), and ldl-c level was significantly associated with risk of gdm (aor=1.162, 95% ci, 1.052 to 1.283) and preterm birth (aor=1.264, 95% ci, 1.065, 1.501).conclusions:early pregnancy high levels of tc, tg, ldl-c and low level of hdl-c may be predictive biomarkers for adverse pregnancy outcomes, while early pregnancy low tc, tg, ldl-c levels and high hdl-c levels could have some protective roles.