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Cord blood lipid profile and associated factors: baseline data of a birth cohort study
Roya Kelishadi1, Zohreh Badiee, Khosrow Adeli
1Preventive Paediatric Cardiology Department, Isfahan Cardiovascular Research Centre, Isfahan University of Medical Sciences, Iran. kroya@aap.net
Insights
Cord blood lipid profiles in newborns are linked to lifelong metabolic health. Maternal pre-pregnancy BMI and fetal growth impact these profiles, suggesting in utero environmental influences on lipid metabolism.
Area of Science:
- Neonatal Health
- Metabolic Disorders
- Public Health
Background:
- Cord blood lipid profiles may influence an individual's lifelong metabolic function.
- Understanding these profiles and their determinants is crucial for early health interventions.
Purpose of the Study:
- To analyze the cord blood lipid profile in Iranian neonates for the first time.
- To investigate environmental factors, such as maternal pre-pregnancy Body Mass Index (BMI) and fetal growth, influencing these profiles.
Main Methods:
- Cross-sectional study of 442 neonates (218 boys, 224 girls) born via normal vaginal delivery.
- Analysis of cord blood lipid parameters including total cholesterol, HDL-C, LDL-C, triglycerides, apolipoprotein A (apoA), and apolipoprotein B (apoB).
- Assessment of neonatal factors like gestational age, small-for-gestational-age (SGA), and large-for-gestational-age (LGA), alongside maternal pre-pregnancy BMI.
Main Results:
- Female neonates had significantly higher total cholesterol and HDL-C than males.
- Maternal underweight/overweight status correlated with lower apoA/higher apoB levels, respectively.
- LGA neonates showed lower HDL-C and apoA, and higher apoB compared to AGA and SGA neonates.
- Maternal pre-pregnancy BMI > 25 kg/m² was associated with increased cord triglycerides and apoB.
- Low maternal pre-pregnancy BMI (<18) correlated with low HDL-C.
Conclusions:
- Cord blood lipid profiles are influenced by fetal growth and maternal pre-pregnancy BMI.
- These findings highlight the role of in utero environmental factors in neonatal lipid metabolism.
- Further longitudinal studies across diverse ethnicities are recommended to fully elucidate these relationships.
Abstract:
The cord blood lipid profile may be associated with lifelong changes in the metabolic functions of the individual. The aim of the present study was for the first time in Iran to assess the cord blood lipid profile of neonates, as well as some of its environmental influencing factors. The subjects were 442 (218 boys and 224 girls) normal vaginal delivery newborns. Overall, 14.4% of neonates were preterm and the rest were full-term. In total, 9.2% (n = 35) of the full-term newborns were small-for-gestational-age (SGA), of which 16 had a ponderal index (PI) below the 10th percentile (SGA I) and 19 had a PI above the 10th percentile (SGA II), 5.5% (n = 21) were large-for-gestational-age (LGA), and the remainder were appropriate-for-gestational-age (AGA).Before becoming pregnant, 6.9% of mothers were underweight, 49.3% had normal body mass index (BMI), 39.4% were overweight and 4.4% were obese. Total and high-density lipoprotein cholesterol (HDL-C) in girls were significantly higher than in boys (80.3 +/- 33.3 and 31.1 +/- 9.9 vs. 73.3 +/- 23.1 and 28.8 +/- 8.7 mg/dL, respectively, P < 0.05). The mean apolipoprotein A (apoA) of neonates with underweight mothers was significantly lower, and the mean apoB level of those with overweight mothers was significantly higher than other neonates. The mean low-density lipoprotein cholesterol (LDL-C), HDL-C and apoA of the LGA newborns were significantly lower, and their apoB was significantly higher compared with AGA and SGA neonates. The SGA I neonates had significantly lower total cholesterol, LDL-C, HDL-C and apoA, as well as higher triglycerides, lipoprotein a and apoB than the SGA II group. The mean cord blood triglycerides of full-term neonates was significantly higher than preterm neonates (69.4 +/- 11.9 vs. 61.4 +/- 12.7 mg/dL, respectively, P = 0.04). A preconception maternal BMI of > or =25 kg/m(2) correlated significantly with the cord triglycerides (OR = 1.3, [95% CI 1.07, 1.5]) and with apoB (OR = 1.4, [95% CI 1.1, 1.5]). The BMI <18 of mothers before pregnancy correlated with low HDL-C (OR = 1.3, [95% CI 1.04, 1.7]). Birthweight correlated with high cord triglyceride level (SGA: OR = 1.4, [95% CI 1.1, 1.7]; LGA: OR = 1.6, [95% CI 1.3, 1.7] compared with AGA). These associations remained significant even after adjusting for the preconception BMI of mothers. Our findings reflect the possible interaction of environmental factors and fetal growth and the in utero lipid metabolism. Long-term longitudinal studies in different ethnicities would help to elucidate the relationship.
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