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Maternal lipid profile in pregnancy and embryonic size: a population-based prospective cohort study
Dionne V Gootjes1,2, Anke G Posthumus3,4, Deveney F Wols3,4
1Department of Obstetrics and Gynecology, Division of Obstetrics and Fetal Medicine, Erasmus MC University Medical Centre, Rotterdam, The Netherlands. d.gootjes@erasmusmc.nl.
Insights
Maternal triglycerides and remnant cholesterol in early pregnancy are linked to larger embryonic size, particularly in overweight women. This suggests early lipid profiles influence embryonic development.
Area of Science:
- Obstetrics and Gynecology
- Metabolic Health
- Embryology
Background:
- Maternal lipids are vital for fetal development and influence birth outcomes.
- Previous research linked maternal lipids to fetal growth in later pregnancy stages.
- The impact of early pregnancy lipid profiles on embryonic size remained unclear.
Purpose of the Study:
- To investigate the association between maternal lipid profiles in early pregnancy and embryonic size.
- To determine if lipid concentrations in the first trimester predict embryonic growth.
Main Methods:
- A cohort of 1474 women from the Generation R Study was analyzed.
- Maternal lipid profiles (total cholesterol, triglycerides, HDL-c, LDL-c, remnant cholesterol, non-HDL-c, TG/HDL-c ratio) and glucose were measured between 10 and 13 weeks of gestation.
- Embryonic size was assessed via crown-rump length (CRL) measurements, with analyses adjusted for confounders.
Main Results:
- Higher maternal triglycerides and remnant cholesterol concentrations were positively associated with larger embryonic size (CRL).
- These associations were more pronounced in overweight women.
- Associations remained significant after adjusting for maternal glucose concentrations.
Conclusions:
- Elevated triglycerides and remnant cholesterol in early pregnancy are associated with increased embryonic size.
- Overweight status may modify the relationship between maternal lipids and embryonic growth.
- Early pregnancy lipid profiles are relevant to embryonic development.
Background:
Lipids are crucial for fetal growth and development. Maternal lipid concentrations are associated with fetal growth in the second and third trimester of pregnancy and with birth outcomes. However, it is unknown if this association starts early in pregnancy or arises later during fetal development. The aim of this study was to investigate the association between the maternal lipid profile in early pregnancy and embryonic size.
Methods:
We included 1474 women from the Generation R Study, a population based prospective birth cohort. Both embryonic size and the maternal lipid profile were measured between 10 weeks + 1 day and 13 weeks + 6 days gestational age. The maternal lipid profile was defined as total cholesterol, triglycerides (TG), high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), remnant cholesterol, non-high-density (non-HDL-c) lipoprotein cholesterol concentrations and the triglycerides/high-density lipoprotein (TG/HDL-c) ratio. Additionally, maternal glucose concentrations were assessed. Embryonic size was assessed using crown-rump length (CRL) measurements. Associations were studied with linear regression models, adjusted for confounding factors: maternal age, pre-pregnancy body mass index (BMI), parity, educational level, ethnicity, smoking and folic acid supplement use.
Results:
Triglycerides and remnant cholesterol concentrations are positively associated with embryonic size (fully adjusted models, 0.17 SDS CRL: 95% CI 0.03; 0.30, and 0.17 SDS: 95% CI 0.04; 0.31 per 1 MoM increase, respectively). These associations were not present in women with normal weight (triglycerides and remnant cholesterol: fully adjusted model, 0.44 SDS: 95% CI 0.15; 0.72). Associations between maternal lipid concentrations and embryonic size were not attenuated after adjustment for glucose concentrations. Total cholesterol, HDL-c, LDL-c, non-HDL-c concentrations and the TG/HDL-c ratio were not associated with embryonic size.
Conclusions:
Higher triglycerides and remnant cholesterol concentrations in early pregnancy are associated with increased embryonic size, most notably in overweight women.
Trial Registration:
The study protocol has been approved by the Medical Ethics Committee of the Erasmus University Medical Centre (Erasmus MC), Rotterdam (MEC-2007-413). Written informed consent was obtained from all participants.
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