Abstract
IntroductionRecent research had shown blood glucose was not the only cause of large for gestational age infant (LGA), the contributions of other fuels such as lipids also play an important role in fetal development. However the association between maternal triglyceride at early trimester and the risk of LGA has not yet been clearly elucidated. This research evaluated the association of maternal early trimester TG level with the risk of LGA infant in Chinese mothers.Methods2839 pregnant women were recruited at the first visit of their perinatal health care and followed up prospectively till after delivery. The demographic, maternal characteristics were extracted from a questionnaire. Infant characteristics were collected at delivery. Maternal fasting serum total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), and low density lipoprotein cholesterol (HDL-C)levels, were measured in 6~8th, 16th, 24th, and 36th gestational weeks. Fasting serum glucose levels were measured at 6~8th, 24th, and 36th gestational weeks. Logistic regression model was used to calculate the odds ratio (OR) and 95% confidence intervals.ResultsA consistently lower TG level was observed in mothers with non-LGA infant than mothers with LGA infant and TG level of mothers of LGA infants increased faster than that of control group. The incidence of LGA infants between two groups (TG<1.7 mmol/L and TG ≥ 1.7 mmol/L) was 14.46 and 26.63%, respectively. Mothers with the highest TG level (TG > 1.19 mmol/L) gave birth to infants with higher birth weight (BW) than the other two groups (TG < 0.70 mmol/L and TG:0.70~0.89 mmol/L). When stratified by pre-pregnancy body mass index (pre-BMI), a significantly positive association was founded between the maternal TG level at early trimester and the risk of LGA in non-overweight/obesity women (OR = 1.740, p = 0.034).ConclusionsThe findings suggested that high maternal TG level at very early trimester was associated with the increased risk of LGA in non-overweight/obesity pregnant women. Moreover, high maternal TG level at first trimester may be an early predictor of LGA.
Highlights
Recent research had shown blood glucose was not the only cause of large for gestational age infant (LGA), the contributions of other fuels such as lipids play an important role in fetal development
Pre-Body mass index (BMI) and Gestational weight gain (GWG) of mothers delivering LGA infant were significantly higher than mothers in control group(23.05 ± 3.19 vs. 21.79 ± 3.04, p < 0.001; 13.72 ± 3.93 vs. 12.69 ± 4.14, p < 0.001 respectively)
There are 27.59% mothers with LGA infant developed gestational diabetes mellitus (GDM) which are significantly higher than 17.97% in control group (p < 0.001)
Summary
Recent research had shown blood glucose was not the only cause of large for gestational age infant (LGA), the contributions of other fuels such as lipids play an important role in fetal development. Serum lipid levels gradually increased from the 12th week of pregnancy, including total cholesterol (TC), triglycerides (TG), low-density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C) and phospholipids, especially in the second and third trimesters [2,3,4] These changes cannot reflect a pathological condition, but they represent a necessary adaptation of the mother’s physiology to satisfy the energy demand of mothers and the fetus as well as to prepare the maternal organism for delivery and lactation [5]. Some studies had shown disturbances in maternal lipid metabolism could induce many kinds of adverse pregnancy outcomes (eg. preeclampsia, gestational diabetes mellitus, and preterm delivery) and that can jeopardize short-term or long-term fetal health (eg. macrosomia, LGA, early cardiovascular disease, metabolic syndrome, insulin resistance) [7,8,9]
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