There is a lack of studies on lipid levels in Vietnamese pregnant women. Our study aimed to describe serum lipid levels of healthy Vietnamese women in the third trimester and identify factors influencing these levels. A cross-sectional study on 1022 healthy females with singleton pregnancy intended to deliver at Bach Mai Hospital recruited from April 2023 to June 2024. Measure fasting serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides at 28-40 weeks of gestation by enzymatic colorimetric assays. Assess factors associated with maternal lipid levels by multivariable linear regression. Median (95% reference range) of TC, LDL-C, HDL-C, and triglycerides were 6.48 (4.39-8.88), 3.33 (1.59-5.52), 1.81 (1.25-2.53), 2.90 (1.65-6.06) mmol/L, respectively. Complicated pregnancy (n = 377) had higher triglycerides and lower cholesterol levels than the uncomplicated pregnancy (n = 645). Factors associated with TC were prepregnancy BMI and gestational age. For LDL-C: prepregnancy BMI, gestational age, and gestational diabetes mellitus (GDM). For HDL-C: prepregnancy BMI and GDM. For TG: prepregnancy BMI, gestational age, GDM, a history of hypertensive disorder in pregnancy, and a history of macrosomia. We presented 95% reference range for the third trimester serum lipid levels in healthy Vietnamese women. Obstetric complications were associated with decreased LDL-C and HDL-C and increased TG, along with gestational age and prepregnancy BMI.

Background Altered maternal serum lipid metabolism is associated with hypertensive disorders in pregnancy (HDP). However, its range in pregnancy and characteristic among different subgroups of HDPs are unclear. Methods Pregnant women with HDP who underwent antenatal care and delivered in Obstetrics and Gynecology Hospital of Fudan University during January 2018 to August 2022 were enrolled. The levels of total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDLC), low-density lipoprotein cholesterol (LDLC), apolipoprotein (Apo)-A, B, and E, free fatty acids (FFA), and small and dense low-density lipoprotein cholesterol (sdLDL) were measured during 4–16 weeks and 28–42 weeks of pregnancy. Results A total of 2648 pregnant women were diagnosed with HDP, 1,880 of whom were enrolled for final analysis, including 983 (52.3%) preeclampsia (PE), 676 (36.0%) gestational hypertension (GH), and 221 (11.7%) chronic hypertension (CH). For all HDPs, serum TC, TG, LDLC, HDLC, Apo-A, Apo-B, Apo-E, and sdLDL increased significantly during pregnancy, while FFA decreased significantly. Notably, the levels of TC, LDLC, Apo-B, and sdLDL in PE group were equal to or lower than those in CH group at 4–16 weeks of pregnancy, but increased greatly during pregnancy (P < 0.05). Conclusions Maternal serum lipid levels changed through pregnancy among women with HDPs. Women complicated with PE seem to have undergone a more significant serum lipid change compared to those with GH or CH.

Impact of maternal BMI and gestational weight gain on maternal serum lipid profiles at term

Maternal serum lipid levels, oxidative stress and antioxidant activity in pre-eclampsia patients from Southwest India.

Prior reports on the association between altered maternal serum lipid levels with preterm delivery are inconsistent. Ethnic differences in serum lipids during pregnancy and their relation to preterm delivery have not been studied. We examined the relationships of six maternal lipids during early pregnancy with the risk of spontaneous preterm delivery (SPTD). The design represents a case-control study nested within a large prospective, multiethnic cohort of young, generally healthy pregnant women. SPTD cases (n = 183) and controls who delivered at term (n = 376) were included. SPTD is defined as delivery at <37 completed weeks of gestation without indicated conditions. We found that African-American women had significantly increased levels of high-density lipoprotein cholesterol (HDL-C) and apolipoprotein A1 (apoA1), and lower triglyceride (TG) and apolipoprotein B (apoB) levels compared to Hispanic and non-Hispanic Caucasians combined. Elevated HDL-C and apoA1 concentrations were significantly associated with an increased odds of SPTD after controlling for potential confounding factors. The adjusted odds ratio (AOR) was 1.91 (95% confidence interval (CI) 1.15, 3.20) for the highest quartile of HDL-C relative to the lowest quartile, and for apoA1 the AOR was 1.94 (95% CI 1.16, 3.24). When controlling for ethnicity, the results remained comparable. These data suggest that pregnant African-American women had a more favorable lipid profile suggestive of a reduction in cardiovascular risk. Despite this, increased HDL-C and apoA1 were both found to be associated with SPTD.

During diabetic pregnancy, complex metabolic changes occur in the lipid profile. The aim of the study was to determine the predictive values of maternal serum lipid levels on large-for-gestational age newborns during the third trimester in pregnancies of women with type 2 diabetes mellitus (DM2) and gestational diabetes mellitus (GDM). Data of forty three pregnancies of women with DM2 and two hundred women with GDM were analyzed. The analysis encompassed the following parameters: age, body mass index (BMI), lipid parameters, HbA1c in first, second and third trimester of pregnancy, preeclampsia and baby birth weight. DM2 and GDM groups showed statistically significant differences in the following variables: total lipids, triglycerides, total cholesterol, BMI, age, baby birth weight, incidence of SGA and preterm delivery (9.4 ± 2.3 vs. 11.0 ± 2.3 mmol/L, 2.4 ± 1.4 vs. 3.4 ± 1.6 mmol/L, 5.5 ± 1.2 vs. 6.4 ± 1.4 mmol/L, 30.6 ± 5.4 vs. 26.9 ± 5.2 kg/m2, 34 ± 7.8 vs. 31.5 ± 5.6 years, 3183 ± 972 vs. 3533 ± 699 g., 20% vs. 7.5%, 27.9 vs. 14%, respectively, p < 0.05). Linear multiple regression analysis demonstrated that triglycerides, LDL-C and total cholesterol were independent predictors of LGA (p < 0.05). Triglycerides and LDL-C in the third trimester of pregnancy are independent predictors for fetal macrosomia in DM2 and GDM pregnancies. Thus, the maternal serum triglycerides and LDL-C levels determined in the maternal blood taken in the third trimester of pregnancy may indentify women who will give birth to LGA newborns.

The aim of this study was to determine the predictive value of maternal serum lipid levels during late pregnancy for neonatal body size. This study was conducted from January 1, 2011 to July 31, 2012 at a Maternal and Child Health Hospital. Fasting blood glucose, serum triglyceride, total cholesterol, HDL and LDL were estimated in maternal collected before delivery. Detailed anthropometry of the neonates was performed. Women who delivered a large for gestational age baby were older, taller, had a higher pre-pregnancy weight, higher pre-pregnancy BMI, and higher weight gain during pregnancy than women who delivered an appropriate for gestational age infant. After adjusting for maternal age, pre-pregnancy BMI, weight gain during pregnancy, parity, neonatal sex and gestational age at delivery, we found that only maternal HDL level was inverse associated with birth weight, length and head circumference (p<0.05). On logistic regression analysis, the significant metabolic predictors of large for gestational age was HDL (OR 0.57, 95%CI: 0.38-0.84, per 1 mmol/L increase) after adjusting for the confounders. Maternal serum HDL level determined in maternal blood taken close to delivery was independently associated with neonatal size and was the independent predictor for large for gestational age.

Objective: To explore the changes in the feature of serum lipid in different trimester of normal pregnancy and GDM, analysis of the effect of diet therapy on blood lipid level on GDM and the relationship between serum and lipid. Methods: 92 normal pregnant women and 85 GDM women were inclusive in this study. The maternal serum lipid levels, diet intake and newborn weight of both groups were recorded. After diet therapy, GDM group was further divided into two subgroups, one with blood glucose under control and one with poor glycemic control according to the blood glucose monitoring. Results: LDL-C and apoB were significantly increased in GDM group compared to normal group in the first trimester(P < 0.05); GDM patients consume more energy having higher weight gain/ pregravid BMI compared to normal group till gestational diabetes was confirmed (P <0.05). Compared to early trimester, TC,TG, LDL-C, LDL-C,apoA1 and apoB were increased in the normal group in late trimester(P <0.05); Compared to the control group in late phase, there was higher apoB, but lower TG in glucose control group. There were higher TC, TG and neonatal weight in the poor glycemic group compared to the control group in late phase (P < 0.05); There was a positive correlation between TC, TG and newbornweight (P < 0.05). Conclusion: With increasing gestational age, there is increasing level of blood lipid profile during pregnancy. Excessive nutrient intake and incidence of GDM may be related. Diet therapy can improve blood lipid status which may help control neonatal weight.

Objective: The aim of the present study was to evaluate whether fasting may cause changes in maternal lipid profile, glucose level and ketonuria, and whether it has any adverse effects on fetal Doppler, birthweight, preterm delivery or cesarean section rate.Methods: Fifty-six consecutive, healthy women with singleton uncomplicated pregnancies of ≥28 week gestation who had fasted for at least 10 consecutive days during the study period were defined as the study group. Fifty-four healthy non-fasted women matched for age, parity, and gestational age were defined as the control group. Groups were compared according to fetal middle cerebral artery and umbilical artery systolic/diastolic ratio, maternal serum lipid levels and neonatal outcomes (gestational age at delivery, birthweight, delivery type and neonatal intensive care admission).Results: No statistical difference was found between the groups according to fetal Doppler parameters, amniotic fluid index, gestational age at delivery, cesarean section rate, birthweight or NICU admission. However, lower levels of VLDL, triglyceride and higher incidence of ketonuria were detected in the fasting group (p < 0.05).Conclusion: Fasting of healthy women during pregnancy seems to have no adverse effects on amniotic fluid index, fetal Doppler and delivery parameters.

Maternal obesity may be associated with metabolic factors that affect the intrauterine environment, fetal growth, and the offspring's long-term risk for chronic disease. Among these factors, maternal serum lipids play a particularly important role. Our objective was to estimate the influence of variation in maternal serum lipid levels on variation in infant birth weight (BW) in overweight/obese and normal weight women. In a prospective cohort of 143 gravidas, we measured maternal serum levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) at 6-10, 10-14, 16-20, 22-26, and 32-36 weeks gestation. Effects of maternal serum lipid levels on infant BW adjusted for gestational age at delivery (aBW) were analyzed using linear regression models. In analyses stratified by maternal prepregnancy BMI categorized as normal (≤25.0 kg/m(2)) and overweight/obese (>25.0 kg/m(2)), we found a significant (P < 0.05) inverse association between aBW and HDL-C at all time points starting at 10 weeks gestation in overweight/obese women. No significant effect was found in normal weight women. In contrast, increased maternal serum TG was significantly associated with increased aBW only for normal weight women at 10-14 and 22-26 weeks gestation. Variation in aBW is not associated with variation in maternal serum TC or LDL-C for either stratum at any time point. We postulate that such differences may be involved in the "physiological programming" that influences later risk of chronic disease in the infants of overweight/obese mothers.

The relationship of neonatal birth weight with maternal serum triglyceride (TG) level has been reported. This hospital‐based cohort study examined the relationship between maternal dietary intake and serum lipid levels in relation to neonatal births weights in 460 pregnant women and their babies. Maternal serum TG and HDL‐cholesterol (HDL‐C) were correlated with intakes of food and nutrients such as cereals and cereal products, meat and meat products, carbohydrates, and polyunsaturated fatty acid. After controlling for maternal age, babies' sex, income and history of low birth weight, the adjusted odds ratio of low birth weight (&lt;2.5kg) delivery was 6.1 (95% confidence intervals, 1.202‐30.707) in women with below the median serum TG level at parturition. The adjusted odds ratio of macrosomia (=4kg) delivery was 0.4 (95% confidence intervals, 0.133‐0.931) in women with above the median serum HDL‐C level. We suggest that maternal lipid levels at parturition of which dietary intake may have partial contribution throughout the pregnancy is associated with birth weight.*This work was supported by the Ministry of Environment and the 2nd stage of Brain Korea 21 project in 2008

Maternal mid-pregnancy serum triglyceride levels and neonatal birth weight

Maternal serum triglyceride at 24–32 weeks’ gestation and newborn weight in nondiabetic women with positive diabetic screens

In Brief Objective To determine whether elevated midpregnancy maternal serum lipid levels predict newborn weight at term and the risk of large for gestational age (LGA) infants in women with positive diabetic screen but normal glucose tolerance test. Methods Japanese gravidas who had positive diabetic screens and normal 75-g oral glucose tolerance tests (GTT) at 24–32 weeks were enrolled. Subjects with complications, including diabetes, hypertension, or fetal anomalies were excluded, as were women with multifetal gestations. Fasting serum triglyceride, free fatty acids, and total cholesterol levels were measured at the time of GTT. We tested the association between maternal variables and birth weight by univariable analysis. We used multivariable analysis to test whether the association between fasting lipids and birth weight was independent of prepregnant maternal body mass index (BMI), maternal weight gain during pregnancy, and plasma glucose levels at GTT. We also used multiple logistic regression analysis to determine whether maternal hyperlipidemia, defined as more than the 75th percentile of each lipid, is a risk factor for having an LGA infant. Results We enrolled 146 subjects. Among measured maternal lipids, only triglyceride levels correlated with birth weight in univariable analysis (r = 0.22, P = .009). Birth weight also was correlated with prepregnant maternal BMI (r = 0.18, P = .04) and fasting plasma glucose levels (r = 0.17, P = .04). The association between maternal fasting triglyceride level and birth weight remained significant after adjusting for prepregnant BMI, maternal weight gain, fasting plasma glucose levels, fetal gender, and gestational age at birth (P = .01). Logistic regression analysis showed that fasting maternal hypertriglyceridemia (over 259 mg/dL) was the significant predictor of LGA infants, independent of prepregnant BMI, maternal weight gain, and maternal plasma glucose levels (odds ratio 11.6; 95% confidence interval 1.1, 122; P = .04). Conclusion In women with positive diabetic screens but normal GTTs, fasting triglyceride levels at 24–32 weeks correlated positively with newborn weight at term, independent of maternal plasma glucose levels and obesity. Maternal fasting serum triglyceride levels in midpregnancy might be an independent predictor of fetal macrosomia in those women. Elevated fasting serum triglyceride levels in midpregnancy were positively associated with newborn weight in nondiabetic women with positive diabetic screen, independent of maternal glucose levels and obesity.

To investigate whether umbilical cord serum lipid levels differ with mode of delivery. Retrospective observation study. Two hundred and ninety mothers aged 29.1 years (SD 4.7) who had vaginal delivery, and 44 mothers aged 30.4 years (SD 4.7) who had elective caesarean section were enrolled. Maternal and umbilical cord blood were obtained immediately after delivery. Serum lipid levels including total cholesterol, high density lipoprotein cholesterol, saturated fatty acid, mono-unsaturated fatty acid and polyunsaturated fatty acid were measured. Obstetric variables and serum lipid levels were compared between the two groups. In each group the correlations of fetal serum lipid levels with maternal serum lipid levels were investigated. There were no significant differences in maternal age, neonatal weight, gestational duration, placental weight and neonatal gender distribution between the two groups. Only the two fetal serum lipid levels (including total cholesterol and non-high density lipoprotein cholesterol) showed a correlation with maternal fetal lipid levels with correlation coefficients > 0.3 in the caesarean section group. However, saturated fatty acid, mono-unsaturated fatty acid and total fatty acid levels in the non-high density lipoprotein low density lipoprotein, very low density lipoprotein, intermediate density lipoprotein and free fatty acid fraction in the umbilical cord serum were significantly higher in the vaginal delivery cases (P < 0.01). Umbilical cord serum levels of saturated and mono-unsaturated fatty acids increase during vaginal delivery.

Aim: To determine whether elevated midpregnancy (24 -28 Gestational weeks) maternal serum lipid levels predict the risk of macrosomia in non-diabetic women. Methods: Nondiabetic pregnant women (who had negative diabetic screens) were enrolled. Fasting serum triglyceride, and total cholesterol levels were measured at 24-28 weeks gestation. We tested the association between maternal variables and birth weight by univariable analysis. We also used multiple logistic regression analysis to determine whether maternal hyperlipidemia is a risk factor for having an LGA infant. Results: We enrolled 190 subjects. Among measured maternal lipids, only triglyceride levels correlated with birth weight in univariable analysis (r2 = 0.40, P = .000). Logistic regression analysis showed that fasting maternal hypertriglyceridemia was the significant predictor of macrosomia, independent of maternal weight gain and fasting plasma glucose levels. (Odds ratio 11.2; 95% confidence interval 1.5, 31.2; P = .01). Conclusion: In nondiabetic women, fasting triglyceride levels at midpregnancy correlated positively with newborn weight at term. Keywords: Birth weight, hypertriglyceridemia, nondiabeic pregnant, normal BMI doi:10.3126/njog.v3i1.1434 NJOG 2008 May-June; 3(1): 19 - 23