Association between Blood Lipid Levels and Macrosomia in Pregnant Women with Different Pre-pregnancy Body Mass Index

Abstract

Background Macrosomia is not only harmful to the pregnant women and newborns, but also to the long-term metabolic health of the offspring. Maternal body mass is closely associated with pregnancy outcomes, overweight and obese pregnant women are often associated with dyslipidemia, while elevated blood lipid levels during pregnancy can affect the intrauterine environment and neonatal birth weight has not been investigated. Objective To analyze the association between blood lipid levels and macrosomia in pregnant women with different pre-pregnancy (BMI) . Methods A total of 5 287 singleton pregnant women who were registered at department of obstetrics of Beijing Obstetrics and Gynecology Hospital, Capital Medical University until delivery from January 2018 to June 2019 and met the inclusion and exclusion criteria were included in the single-center retrospective study, and divided into low-body-mass pregnant women with a non-macrosomia group (group A, n=731) and with a macrosomia group (group B, n=27) , normal-body-mass pregnant women with a non-macrosomia group (group C, n=3 539) and with a macrosomia group (group D, n=243) , overweight and obese pregnant women with a non-macrosomia group (group E, n=675) and with a macrosomia group (group F, n=72) according to maternal pre-pregnancy BMI and neonatal birth weight. Relevant clinical and laboratory data of pregnant women were collected for statistical analysis. Binary Logistic regression analysis was used to explore the association between blood lipid levels and macrosomia in pregnant women with different pre-pregnancy BMI. Results The level of high-density lipoprotein cholesterol (HDL-C) in the third trimester of pregnancy in group B was lower than group A (P<0.05) . The levels of total cholesterol (TC) in the first trimester and triglyceride (TG) in the third trimester in group D were higher than group C (P<0.05) , while the levels of HDL-C in the second and third trimesters were lower than group C (P<0.05) . The TG levels in the first, second and third trimesters of pregnancy in group F were higher than group E (P<0.05) , while HDL-C levels in the second and third trimesters were lower than group E (P<0.05) . Binary Logistic regression analysis showed that HDL-C level in the third trimester〔OR=0.256, 95%CI (0.075, 0.871) 〕 was the influencing factor of macrosomia in low body mass pre-pregnancy women (P<0.05) . HDL-C levels in the second and third trimesters〔OR=0.661, 95%CI (0.450, 0.971) ; OR=0.406, 95%CI (0.271, 0.610) 〕 were the influencing factors of macrosomia in normal body mass pre-pregnancy women (P<0.05) . TG levels in the first, second and third trimesters〔OR=1.546, 95%CI (1.070, 2.234) ; OR=1.399, 95%CI (1.019, 1.758) ; OR=1.289, 95%CI (1.072, 1.550) 〕 were the influencing factors of macrosomia in overweight and obese pre-pregnancy women (P<0.05) . Conclusion For pre-pregnancy women with low and normal body mass, low HDL-C level during pregnancy is associated with an increased risk for macrosomia, while for overweight and obese pre-pregnancy women, high TG level during pregnancy is associated with an increased risk of macrosomia. For pregnant women with large fetuses or high risk of macrosomia during maternal examination, it is necessary to emphasize the detection and control of blood lipid levels.

Keywords

• body mass index|pregnancy|pregnant women|blood lipids|fetal macrosomia|pregnancy complications|root cause analysis