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Published on: October 12, 2017
Advanced lipoprotein measures and recurrent preterm birth
John M Thorp1, Madeline Murguia Rice, Margaret Harper
1Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC.
Insights
Lipoprotein particle size, specifically very low-density lipoprotein (VLDL), may influence preterm birth (PTB) risk. Further research into VLDLNMR particle size could inform interventions for preventing PTB.
Area of Science:
- Cardiovascular Science
- Reproductive Science
- Metabolic Science
Background:
- Lipoproteins are implicated in atherogenic and inflammatory pathways.
- These processes may contribute to adverse pregnancy outcomes, including preterm birth (PTB).
Purpose of the Study:
- To investigate the association between lipoprotein particle size and concentration and the risk of PTB.
- To determine if lipoprotein variations are linked to PTB occurring before 35 weeks' gestation.
Main Methods:
- A case-control study analyzed plasma samples from 128 PTB cases and 132 term controls.
- Nuclear magnetic resonance (NMR) spectroscopy characterized 17 lipoprotein particles.
- Logistic regression models controlled for relevant covariates.
Main Results:
- Only one lipoprotein particle size, very low-density lipoprotein (VLDL) NMR particle size, showed a significant association with PTB.
- Increased VLDLNMR particle size correlated with a higher odds of PTB.
Conclusions:
- Midpregnancy lipoprotein variations were not broadly associated with recurrent PTB in women with a history of PTB.
- The observed association with VLDLNMR particle size suggests potential targets for lifestyle, nutritional, or pharmacologic interventions to prevent PTB.
Objective:
Lipoproteins are associated with atherogenic and inflammatory processes, and these processes may be related to adverse pregnancy outcomes. We therefore examined whether variations in lipoprotein particle size and concentration are associated with preterm birth (PTB) <35 weeks' gestation.
Study Design:
This is a case-control ancillary study to a randomized trial of omega-3 fatty acid supplementation to prevent recurrent PTB. We measured standard lipids and used nuclear magnetic resonance (NMR) spectroscopy to characterize 17 lipoprotein particles from plasma collected at the baseline randomization visit (16-21 weeks' gestation) in 128 cases (PTB <35 weeks' gestation) and 132 term controls. Logistic regression models controlled for study center, race/ethnicity, number of prior PTB, smoking, and treatment group, as well as total low-density lipoprotein (LDL), high-density lipoprotein, and triglyceride concentrations when examining LDLNMR, high-density lipoproteinNMR, and very LDL (VLDL)NMR, respectively.
Results:
Only 1 of the 17 NMR lipoproteins was associated with recurrent PTB. We observed an increased odds of recurrent PTB of 1.04 (95% confidence interval, 1.01-1.08; P = .02) per nanometer increase in VLDLNMR particle size and an odds ratio of 3.00 (confidence interval, 1.40-6.43; P = .005) for the third tertile of VLDLNMR particle size compared with the first tertile.
Conclusion:
In women with prior PTB, variations in midpregnancy lipoproteins were not associated with recurrent PTB overall, however the association observed with VLDLNMR particle size is suggestive that PTB may be amenable to lifestyle, nutritional, or pharmacologic interventions.
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