706: Maternal dyslipidemia and risk for preterm birth

Abstract

To investigates the association between maternal dyslipidemia and subsequent preterm birth among pregnant women in the state of California. Births were identified from California birth certificate and hospital discharge records from 2007-2012 (N=2,870,449). Preterm birth was defined as <37 completed weeks of gestation and dyslipidemia was defined by the ICD-9 codes 272.0-272.4. Subtypes of preterm birth were classified as PPROM, spontaneous, and medically indicated, according to birth certificate data and ICD-9 codes. The association between dyslipidemia and preterm birth was tested using logistic regression. Stratified models were fit comparing each subtype of preterm birth to term birth. For all associations, independent models and adjusted models were fit (adjusted for maternal age at delivery, race/ethnicity, hypertension, body mass index, insurance coverage, and maternal education). Of the 2,870,449 women included in analysis, 9,026 had dyslipidemia. Among all subjects, dyslipidemia was significantly associated with increased odds of preterm birth in the unadjusted (OR: 2.306; 95% CI: 2.176, 2.445) and adjusted analyses (OR: 1.475; 95% CI: 1.378, 1.579). Dyslipidemia was also associated with increased risk for subtypes of preterm birth, including PPROM (adjusted OR: 1.549; 95% CI: 1.348, 1.780), spontaneous (adjusted OR: 1.494; 95% CI: 1.367, 1.632), and medically indicated (adjusted OR: 1.448; 95% CI: 1.275, 1.644). Few studies have investigated the association between chronic pre-pregnancy dyslipidemia and risk for preterm birth. The results of this study suggest that chronic pre-pregnancy dyslipidemia is associated with increased risk for preterm birth, in particular medically indicated preterm birth. These findings identify dyslipidemia as a potential factor in the etiology and clinical prediction of preterm birth, although causality remains to be determined.