The Impact of Gestational Weight Gain on the Risks of Adverse Maternal and Infant Outcomes among Normal BMI Women with High Triglyceride Levels during Early Pregnancy.

Xia-Fei Jiang,Hui Wang,Dan-Dan Wu,Yan-Ting Wu,Jian Zhang,He-Feng Huang,Xian-Hua Lin,Jian-Lin Zhang,Ling Gao,Lei Chen,Jian-Xia Fan

doi:10.3390/nu13103454

Abstract

A high maternal triglyceride (mTG) level during early pregnancy is linked to adverse pregnancy outcomes, but the use of specific interventions has been met with limited success. A retrospective cohort study was designed to investigate the impact of gestational weight gain (GWG) on the relationship between high levels of mTG and adverse pregnancy outcomes in normal early pregnancy body mass index (BMI) women. The patients included 39,665 women with normal BMI who had a singleton pregnancy and underwent serum lipids screening during early pregnancy. The main outcomes were adverse pregnancy outcomes, including gestational hypertension, preeclampsia, gestational diabetes, cesarean delivery, preterm birth, and large or small size for gestational age (LGA or SGA) at birth. As a result, the high mTG (≥2.05mM) group had increased risks for gestational hypertension ((Adjusted odds ratio (AOR), 1.80; 95% CI, 1.46 to 2.24)), preeclampsia (1.70; 1.38 to 2.11), gestational diabetes (2.50; 2.26 to 2.76), cesarean delivery (1.22; 1.13 to 1.32), preterm birth (1.42, 1.21 to 1.66), and LGA (1.49, 1.33 to 1.68) compared to the low mTG group, after adjustment for potential confounding factors. Additionally, the risks of any adverse outcome were higher in each GWG subgroup among women with high mTG than those in the low mTG group. High mTG augmented risks of gestational hypertension, preeclampsia, preterm birth, and LGA among women with 50th or greater percentile of GWG. Interestingly, among women who gained less than the 50th percentile of GWG subgroups, there was no relationship between high mTG level and risks for those pregnancy outcomes when compared to low mTG women. Therefore, weight control and staying below 50th centile of the suggested GWG according to gestational age can diminish the increased risks of adverse pregnancy outcomes caused by high mTG during early pregnancy.

Highlights

Introduction distributed under the terms andThe accumulation of lipids in maternal metabolism, as well as the development of maternal hyperlipidemia, are essential characteristics of maternal lipidomic variation during pregnancy, and maternal lipid metabolism has an essential role in fetal growth and late pregnancy outcomes
These results strongly suggest that limiting gestational weight gain could likely prevent major adverse maternal and infant outcomes contributed to by high maternal blood triglyceride (mTG) during early pregnancy
Our results indicate that high maternal TG levels during the first gestational period are associated with a high incidence of adverse pregnancy outcomes, both in maternal and fetal aspects for females with normal body mass index (BMI)

Summary

Introduction

The accumulation of lipids in maternal metabolism, as well as the development of maternal hyperlipidemia, are essential characteristics of maternal lipidomic variation during pregnancy, and maternal lipid metabolism has an essential role in fetal growth and late pregnancy outcomes. Maternal blood triglyceride (mTG) is a critical conditions of the Creative Commons. Energy supplier, and its concentration alters to enhance the utilization of substrates critical for fetal growth and development during pregnancy [1]. Triglyceride levels increase in all pregnancies regardless of BMI as a normal physiological function of pregnancy [2–5]. It has been shown that the increase of mTG is not always dependent on maternal BMI [6]. The majority of pregnant women—even those with normal BMI—are at high risk for elevated triglyceride levels; they are at an increased risk for adverse maternal and fetal outcomes

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