Abstract
BackgroundBlood lipid increases during gestation are considered a physiological adaption, and decrease after delivery. However, some adverse pregnancy outcomes are thought to be related to gestational lipid levels. Therefore, it is necessary to have a reference range for lipid changes during gestation. The present study aims to describe triglyceride (TG) changes during pregnancy and 42 days postpartum and to find cut-off points for TG levels during the first, second, and third trimesters.MethodsA total of 908 pregnant women were followed from recruitment to 42 days postpartum, and their serum lipids were collected at gestational weeks 6–8, 16, 24, and 36 and 42 days postpartum. The major outcome was postpartum hypertriglyceridemia. The association between gestational and postpartum TG levels was analysed by stepwise multiple linear regression. A two-stage approach including a linear mixed-effect model and linear or logistic regression was conducted to explore the contribution of the changes in TG over time in pregnancy to postpartum hypertriglyceridemia. Logistic regression was constructed to examine the association between gestational TG levels and postpartum hypertriglyceridemia. Cut-off points were calculated by receiver operating characteristic (ROC) curves.ResultsThere was a tendency for serum TG to increase with gestational age and decrease at 42 days postpartum. Prepregnancy overweight, obesity, and GDM intensified this elevation. Higher TG levels at gestational weeks 6–8, 16, 24, and 36 were positively associated with a higher risk of postpartum hypertriglyceridemia [OR 4.962, 95 % CI (3.007–8.189); OR 2.076, 95 % CI (1.303–3.309); OR 1.563, 95 % CI (1.092–2.236); and OR 1.534, 95 % CI (1.208–1.946), respectively]. The trend of the change in TG over time was positively associated with the TG level and risk of postpartum hypertriglyceridemia [OR 11.660, 95 % CI (6.018–22.591)]. Based on ROC curves, the cut-off points of serum TG levels were 1.93, 2.35, and 3.08 mmol/L at gestational weeks 16, 24, and 36, respectively. Stratified analysis of prepregnancy body mass index (pre-BMI) and GDM showed that higher gestational TG was a risk factor for postpartum hypertriglyceridemia in women with normal pre-BMI and without GDM.ConclusionsGestational TG and its elevation were risk and predictive factors of postpartum hypertriglyceridemia, especially in pregnant women with normal pre-BMI or without GDM.
Highlights
Blood lipid increases during gestation are considered a physiological adaption, and decrease after delivery
Higher serum TG levels in pregnancy are closely associated with the risk of pregnancy complications such as gestational diabetes mellitus (GDM) [4], preeclampsia (PE) [5], and intrahepatic cholestasis of pregnancy (ICP) [6] and adverse pregnancy outcomes such as preterm birth [2], large for gestational age (LGA) infants [7], and macrosomia [8]
The present study indicated that TG levels during gestation and their change rate per gestational week were both risk factors for postpartum hypertriglyceridemia, especially increased levels during the first trimester
Summary
Blood lipid increases during gestation are considered a physiological adaption, and decrease after delivery. Some adverse pregnancy outcomes are thought to be related to gestational lipid levels. The present study aims to describe triglyceride (TG) changes during pregnancy and 42 days postpartum and to find cut-off points for TG levels during the first, second, and third trimesters. Maternal lipid increases throughout pregnancy are thought to be a physiological response to gestation [1]. Adank et al found that high maternal TG in gestation was positively associated with blood pressure and sustained hypertension even 6 and 9 years after pregnancy [10]. Disorders of lipid metabolism can be long-lasting, and the potential risk of CVD and chronic metabolic diseases may threaten women’s longterm health if elevated TGs in pregnancy cannot return to normal after delivery
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