Jsmc-10390

ASSOCIATION BETWEEN MATERNAL SERUM LIPID PROFILE AT LATE GESTATION WITH NEONATAL MACROSOMIA

Salama Kamel Nasir a, Rawaa Mahfoudh Khaleel a, and Naz Azad Abdullah a

a College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.

 

Submitted: 27/5/2022; Accepted: 21/10/2022; Published: 21/12/2022

DOI Link: https://doi.org/10.17656/jsmc.10390 

ABSTRACT 

Background 

Macrosomia is a serious health problem that is highly prevalent and can negatively affect neonatal and maternal outcomes. Pregnant women and neonates can be negatively influenced by dyslipidemia (high maternal serum lipids) which also results in the development of fetal macrosomia..

Objectives 

The current study aimed to determine how maternal lipid profile during the third trimester of pregnancy correlated with fetal birthweight. 

Patients and Methods

A prospective cohort study was conducted in Sulaimani Maternity Teaching Hospital over eight months, starting from the 1st of September 2018 till the 30th of April 2019. The study included 123 pregnant with a viable singleton pregnancy, gestational age > 32 weeks, delivered between 37 and 42 weeks of gestational age, and women suffering from thyroid disorders and hypertension. For all women, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and serum triglycerides (TG) were measured. In addition, the women were followed up until their childbirth, and the correlation between the mothers’ lipid profile and their neonates’ weight was measured..

Results

The mean age ± SD (standard deviation) of the studied women was   31.10± 3.65 years, ranging from (25 to 38) years. Regarding their parity, 78% of women were multiparous (have 2-4 children), and the remaining (22%) were primipara. Among the 123 participating women, 23 (18.7%) delivered macrosomic babies (weight > 4kg), and 100 (81.3%) delivered babies with normal birth weight. Fifteen women (12.2%) have high cholesterol levels, and all delivered macrosomic newborns, with a statistically significant association (P=0.001) between macrosomia and maternal cholesterol level. Also, the prevalence of macrosomia was significantly higher among women with high serum triglyceride levels (P=0.001). 

Conclusion

There is a significant association between increased risk of macrosomia and high serum cholesterol and triglycerides levels during pregnancy.

KEYWORDS

Macrosomia, lipid profile, dyslipidemia, pregnancy.

References 

1. World Health Organization. Maternal lipid level on pregnant women .2019-012. [updated 2019; cited the 12th of January 2019]. Available from: https://www.who.int/topics/pregnancy/en 

2. Kumawat M, Kumawat D, Singh CH, Sharma LN, Purvia PRA, Adlakha M. Diet    management      during    pregnancy.    European    Journal of biomedical and pharmaceutical sciences. 2018; 5(4): 261-266.

3. American college obstetrics and gynecology, How Your Fetus Grows During Pregnancy - ACOG. Acog.org.updated 2019 [cited the 13th of January 2019]. Available from: https://www.acog.org/Patients/FAQ

4. Mankuta D, Elam-Suzin M, Elhayani A, Tinker S. Lipid profile in consecutive pregnancies. Lipids in health and disease. 2010; 9(1):58.

5. Pusukuru R, Shenoi AS, Kyada PK, Ghodke B, Mehta V, Bhuta K, et al. Evaluation of lipid profile in the second and third trimester of pregnancy. Journal of clinical and diagnostic research. 2016; 10(3): QC12.

6. Herrera   E, Ortega-Senovilla H. Lipid metabolism during pregnancy and its implications for fetal growth. Current pharmaceutical biotechnology. 2014; 15(1):24-31.

7. Geraghty AA, Alberdi G, O’Sullivan EJ, O’Brien EC, Crosbie B, Twomey PJ, et al. Maternal and fetal blood lipid concentrations during pregnancy differ by maternal body mass index: findings from the ROLO study. BMC pregnancy and childbirth. 2017; 17(1):36.

8. Jin WY, Lin SL, Hou RL, Chen XY, Han T, Jin Y, et al. Associations between maternal lipid profile and pregnancy complications and perinatal outcomes: a population-based study from China. BMC pregnancy and childbirth; 2016 16(1):60.

9. Grimes SB, Wild R. Effect of Pregnancy on Lipid Metabolism and Lipoprotein Levels. In: Endotext; 2018. 20 (1):60.

10. Wiznitzer A, Mayer A, Novack V, Sheiner E, Gilutz H, Malhotra A, et al. Association of lipid levels during gestation with pre-eclampsia and gestational diabetes mellitus: a population-based study. Am J Obstet Gynecol. 2009; 201(5):482 e1-8.

11. Blackburn S. Maternal, Fetal, & Neonatal Physiology-E-Book. Elsevier Health Sciences. 3rd ed. Elsevier; 2014. 

12. Ryckman KK, Spracklen CN, Smith CJ, Robinson JG, Saftlas AF. Maternal lipid levels during pregnancy and gestational diabetes:  a systematic review and meta-analysis. International Journal of Obstetrics & Gynecology. 2015; 122(5):643-51.

13. Vrijkotte TG, Krukziener N, Hutten BA, Vollebregt KC, van Eijsden M, Twickler MB, et al. Maternal lipid profile during early pregnancy and pregnancy complications and outcomes: the ABCD study. The Journal of Clinical Endocrinology & Metabolism. 2012; 97(11):3917-3919.

14. Hou RL, Zhou HH, Chen XY, Wang XM, Shao J, Zhao ZY. Effect of maternal lipid profile, C-peptide, insulin, and HBA1c levels during late pregnancy on large-for-gestational-age newborns. World Journal of Pediatrics. 2014; 10(2):175-81.

15. Mossayebi E, Arab Z, Rahmaniyan M, Almassinokiani F, Kabir A, et al. prediction of neonates' macrosomia with maternal lipid profile of healthy mothers. Pediatrics & Neonatology. 2014; 55(1):28-34.

16. Retnakaran R, Ye C, Hanley AJ, Connelly PW, Sermer M, Zinman B, et al. Effect of maternal weight, adipokines, glucose intolerance and lipids on infant birthweight among women without gestational diabetes mellitus. Canadian Medical Association Journal. 2012; 184 (12): 1353-1360.

17. Sommer C, Sletner L, Mørkrid K, Jenum AK, Birkeland KI. Effects of early pregnancy BMI, mid-gestational weight gain, glucose and lipid levels in pregnancy on offspring’s birthweight and subcutaneous fat: a population-based cohort study. BMC pregnancy and childbirth. 2015; 15(1):84.

18. Amarasingha S, Dinusha AA, Nasrina MF, Hewawasam RP, de Silva DE, Aruna M, et al. effect of maternal lipid levels during late pregnancy on the birth of large for gestational age newborns in a tertiary care setting in southern Sri Lanka. Journal of clinical & diagnostic research. 2018; 12(6):66–69.

19. Gluckman PD, Hanson MA, Cooper C. In Utero and Early-life Conditions and Adult Health and Disease. The New England Journal of Medicine. 2008; 359(14):1524.

20. Jan MR, Nazli R, Shah J, Akhtar T. A study of lipoproteins in normal and pregnancy-induced hypertensive women in tertiary care hospitals of the northwest frontier Province-Pakistan. Hypertension in pregnancy. 2012; 31(2):292-9.

21. Fuchs F, Bouyer J, Rozenberg P, Senat MV. Adverse maternal outcomes associated with fetal macrosomia: what are the risk factors beyond birthweight. BMC pregnancy and childbirth. 2013; 13(1):90.

22. Azadbakht L, Kelishadi R, Saraf-Bank S, Qorbani M, Ardalan G, Heshmat R, et al. The association of birthweight with cardiovascular risk factors and mental problems among   Iranian school-aged children:   the   CASPIAN-III studies. Nutrition. 2014; 30(2):150-8.

23. Ogonowski J, Miazgowski T, Engel K, Celewicz Z. Birthweight predicts the risk of gestational diabetes mellitus and pregravid obesity. Nutrition. 2014; 30(1):39-43.

24. Koyanagi A, Zhang J, Dagvadorj A, Hirayama F, Shibuya K, Souza JP, et al. macrosomia in 23 developing countries: an analysis of a multicountry, facility-based, cross-sectional survey. The Lancet. 2013; 381(9865):476-83.

25. Munim S, Maheen H. Association of gestational weight gain and pre-pregnancy body mass index with adverse pregnancy outcome. J Coll Physicians Surg Pak. 2012; 22(11):694-697.

26. Kayode-Adedeji B, Egharevba O, Omoregbee H. Prevalence of fetal macrosomia and neonatal complications in a Nigerian suburban hospital: a five-year study. Journal of Pediatric and Neonatal Individualized Medicine (JPNIM). 2018;7(1):1–5.

27. Obstetrics and   Gynecology. 7th ed, American college of obstetricians and Gynecologists with Chares R. B. Beckmann, MD, MHPE, FACOG, Robert Casanova, MD, FACOG other, (Medical and surgical disorder in pregnancy); 2014 ch 2 p 23 Ch. 20 p. 191-198. 

28. Langer O. Fetal macrosomia, etiologic factors. Clin Obstet Gynecol. 2000; 43(2):283-297.

29. Kulkarni SR, Kumaran K, Rao SR, Chougule SD, Deokar TM, Bhalerao AJ, et al. Maternal lipids are as important as glucose for fetal growth: findings from the Pune Maternal Nutrition Study. Diabetes Care. 2013; 36(9):2706-13.

30. Cheng YW, Sparks TN, Laros RK, Jr., Nicholson JM, Caughey AB. Impending macrosomia: will induction of labour modify the risk of cesarean delivery BJOG;2012 119(4):402-9.

31. Woollett LA. Maternal cholesterol in fetal development, transport of cholesterol from the maternal to the fetal circulation. The American journal of clinical nutrition; 2005; 82(6):1155-61.

Full Text

 © The Authors, published by University of Sulaimani, College of Medicine

This work is licensed under a Creative Commons Attribution 4.0 International License.