Abstract
We evaluated the relationship between maternal cholesterol levels and its biologically active precursors and metabolites in the first trimester and subsequent risk for small-for-gestational-age birthweight (SGA). This is a secondary analysis of a prospective cohort study which enrolled healthy singleton pregnancies (n = 1337). Maternal fasting blood was taken in the first trimester and followed up till delivery. The lipid parameters were compared between women who delivered SGA neonates (SGA-group, birthweight < 10th percentile, n = 107) and women who did not (non-SGA-group, n = 1230). In addition, metabolic signatures of cholesterol were evaluated in a subset consisting of propensity-score matched SGA (n = 56) and control group (n = 56). Among lipid parameters, maternal high-density lipoprotein cholesterol (HDL-C) levels were significantly lower in SGA-group than in non-SGA-group (p = 0.022). The risk for SGA was negatively correlated with maternal serum HDL-C quartiles (p = 0.003), and this association remained significant after adjustment for confounding variables. In metabolic signatures of cholesterol, the cholesterol/lathosterol ratio in SGA-group was significantly higher than non-SGA-group [(2.7 (1.6–3.7) vs. 2.1 (1.5–2.9), respectively; p = 0.034)], suggesting increased endogenous cholesterol biosynthesis. We demonstrated that dyslipidemia and increased cholesterol biosynthesis led to delivery of SGA neonates even in early pregnancy.
Highlights
We evaluated the relationship between maternal cholesterol levels and its biologically active precursors and metabolites in the first trimester and subsequent risk for small-for-gestational-age birthweight (SGA)
There are only a few preceding studies on this topic without consistent findings; one study reported there was no association between SGA and the lipid level during the first t rimester13 whereas another study reported high high-density lipoprotein cholesterol (HDL-C) level in early pregnancy was associated with lower birth w eight14
The principal findings of this study were: [1] the levels of maternal HDL-C at 10–14 weeks in SGA neonates were significantly lower than those of non-SGA-group; [2] the risk for SGA showed negative relationship with maternal serum HDL-C quartiles at 10–14 weeks of gestational age; [3] for metabolic signature of maternal
Summary
We evaluated the relationship between maternal cholesterol levels and its biologically active precursors and metabolites in the first trimester and subsequent risk for small-for-gestational-age birthweight (SGA). This is a secondary analysis of a prospective cohort study which enrolled healthy singleton pregnancies (n = 1337). Maternal high-density lipoprotein cholesterol (HDL-C) levels were significantly lower in SGA-group than in non-SGA-group (p = 0.022). One of the suggested mechanism is atherosclerosis of basal arterioles and diffuse lipid infiltration of the placental bed, leading to an obstructive v asculopathy6 This abnormal accumulation of lipid could result in pathological. The results on the effect of dyslipidemia during pregnancy on fetal growth has been conflicting
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