56. Maternal lipid profile in early pregnancy as marker for adverse perinatal outcomes

Introduction Metabolic syndrome, characterized by abdominal obesity, insulin resistance, hypertension and hyperlipidemia has become a major health problem of the modern world. Metabolic syndrome is associated with adverse perinatal outcomes, such as a neonate born large for gestational age (LGA). Little is known about the role of maternal lipid concentrations in this association. Possibly, an atherogenic lipid profile in early pregnancy is a risk factor for adverse perinatal outcomes. Objective To determine the association of maternal glucose and lipid concentrations in early pregnancy with perinatal outcomes: LGA, small for gestational age (SGA), and spontaneous preterm birth (sPTB). Methods We included 5692 women from The Generation R Study; a prospective population-based birth cohort. Maternal glucose and lipid concentrations including triglycerides, total-cholesterol, high-density lipoprotein-cholesterol (HDL-c) were measured in early pregnancy (median 13.4 weeks). Low-density lipoprotein-cholesterol (LDL-c), remnant-cholesterol and non-HDL-c were calculated. A birth weight above the 90th percentile was defined as LGA and below the 10th percentile as SGA. Spontaneous birth before 37 weeks of gestation was defined as sPTB. Results Triglycerides and remnant-cholesterol were positively associated with the risk for LGA. These associations were partly mediated by maternal glucose concentrations in early pregnancy (10.9% and 9.0% respectively). HDL-c was negatively associated with the risk for LGA. Women with an atherogenic lipid profile (high triglycerides with either high total-cholesterol, high remnant-cholesterol or low HDL-c) were most at risk for a LGA child. We observed no associations between lipid concentrations in early pregnancy and the risk for SGA or sPTB. Discussion An atherogenic lipid profile in early pregnancy is associated with a higher risk for a LGA child. This association is partly mediated by maternal glucose concentration in early pregnancy. Assessing maternal lipid profile in early pregnancy might help to identify high-risk pregnancies in an early stage.