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Associations between maternal mid-pregnancy apolipoprotein A-1, apolipoprotein B, apolipoprotein B/apolipoprotein A-1
Qing Liu1, Li Wu2, Lulin Wang1
1Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Insights
Elevated maternal apolipoprotein B (ApoB) and ApoB/ApoA-1 ratio in mid-pregnancy are linked to a higher risk of preterm birth. Monitoring these lipid markers may help identify at-risk pregnancies.
Area of Science:
- Reproductive Medicine
- Biochemistry
- Public Health
Background:
- Elevated lipid levels in pregnancy are associated with preterm birth risk.
- Apolipoproteins (Apo) are crucial for lipid metabolism, but their role in pregnancy and preterm birth is understudied.
Purpose of the Study:
- To investigate the association between maternal serum apolipoprotein A-1 (ApoA-1), apolipoprotein B (ApoB), and the ApoB/ApoA-1 ratio with preterm birth risk.
Main Methods:
- Data from 5,986 maternal-newborn pairs at Guangdong Women and Children Hospital.
- Maternal serum ApoB, ApoA-1, and ApoB/ApoA-1 ratio measured in mid-pregnancy (median 18 weeks).
- Logistic regression models used to calculate odds ratios (OR) and 95% confidence intervals (CI) for preterm birth.
Main Results:
- Preterm birth occurred in 5.7% of cases.
- High ApoB (>90th percentile) was associated with increased preterm birth risk (OR: 1.51, 95% CI: 1.06-2.10).
- High ApoB/ApoA-1 ratio (>90th percentile) also increased preterm birth risk (OR: 1.64, 95% CI: 1.18-2.24).
- Low ApoB (<10th percentile) showed a protective association (OR: 0.63, 95% CI: 0.38-0.99).
- Associations were significant in specific subgroups: women with BMI 18.5-24 kg/m² and women aged ≥35 years.
Conclusions:
- Elevated maternal ApoB and ApoB/ApoA-1 ratio in mid-pregnancy are significant predictors of increased preterm birth risk.
- Monitoring serum apolipoprotein levels could aid in identifying pregnancies at high risk for preterm birth.
- Further research may elucidate the precise mechanisms linking these lipid markers to adverse pregnancy outcomes.
Background And Aims:
Elevated lipid levels during pregnancy have been shown to be related to the risk of preterm birth. Despite the importance of apolipoprotein (Apo) in lipid metabolism and transportation, evidence regarding apolipoprotein levels during pregnancy and preterm birth is still limited. Therefore, we aim to investigate the associations between maternal ApoA-1, ApoB, ApoB/ApoA-1 ratio and preterm birth.
Materials And Meth:
Data were extracted from the information system of Guangdong Women and Children Hospital. Lipoprotein levels were tested using Beckman Coulter AU5800 in mid-pregnancy at a median gestational age of 18 w. Maternal serum ApoB, ApoA-1 and ApoB/ApoA-1 ratio were categorized into tertiles. Logistic regression models were performed to evaluate the odds ratios and 95% confidence intervals for preterm birth.
Results:
A total of 5,986 maternal-newborn pairs were included in this study. The rate of preterm birth was 5.7% (n = 344). The multivariate-adjusted ORs (95% CI) of preterm birth were 1.51 (1.06, 2.10) for individuals with high ApoB (>90th), 0.63 (0.38, 0.99) for those with low ApoB (<10th), and 1.64 (1.18, 2.24) for those with high ApoB/ApoA-1 (>90th). Subgroup analyses showed that the association of ApoB and preterm birth was only significant among women with pre-pregnancy BMI 18.5-24 kg/m2 (OR = 1.36, 95% CI: 1.12-1.65), age at delivery ≥ 35 years (OR = 1.43, 95% CI: 1.12-1.83).
Conclusion:
Elevated maternal ApoB level and ApoB/ApoA-1 ratio during mid-pregnancy were related to increased risk of preterm birth. Monitoring maternal serum apolipoprotein levels may help to identify the high-risk population of preterm birth.
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