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Preconception lipid profile and the subsequent risk of pregnancy disorders characterized by uteroplacental
Renée J Burger1, Annemarie Y A M Reilingh2, Eric P Moll Van Charante3
1Department of Obstetrics and Gynaecology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands (Dr. Burger, Dr. Ravelli and Dr. Ganzevoort); Amsterdam Reproduction and Development, Pregnancy and Birth, Amsterdam, The Netherlands (Dr. Reilingh, Drs Groot, Ravelli, Weissenbruch, and Ganzevoort); Department of Obstetrics and Gynaecology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands (Drs. Burger and Gordijn).
Insights
Preconception lipid profiles, including triglyceride levels, did not effectively predict pregnancy disorders like hypertensive disorders. Current prediction models for pregnancy complications do not benefit from including lipid levels.
Area of Science:
- Obstetrics and Gynecology
- Cardiovascular Health
- Reproductive Medicine
Background:
- Unfavorable lipid profiles are linked to pregnancy disorders stemming from uteroplacental dysfunction.
- Existing prediction tools for pregnancy complications do not incorporate lipid levels.
Purpose of the Study:
- To investigate the association between preconception lipid profiles and uteroplacental dysfunction-related pregnancy disorders.
- To enhance risk identification for women susceptible to uteroplacental dysfunction using current prediction models.
Main Methods:
- A multi-ethnic cohort study linked preconception lipid profiles with national perinatal registry data.
- 1177 women of diverse ethnic backgrounds were included in the analysis.
- Poisson regression and assessment of discriminative ability were employed.
Main Results:
- Preconception triglyceride levels showed a marginal association with hypertensive disorders of pregnancy.
- While some lipid parameters indicated higher prevalence, adjustments for confounding factors diminished statistical significance.
- Incorporating lipid levels into existing prediction tools did not improve their accuracy for predicting pregnancy complications.
Conclusions:
- Preconception lipid profiles were not found to be useful for identifying women at high risk for pregnancy disorders.
- Further research is necessary to develop improved prediction models using novel biomarkers or accessible measurements.
Background:
Unfavorable lipid profile is associated with pregnancy disorders characterized by uteroplacental dysfunction, including hypertensive disorders of pregnancy, preterm birth and fetal growth restriction. None of current tools used to predict the risk of pregnancy complications include lipid levels.
Objective(S):
In this study, we examined the association of preconception lipid profile with pregnancy disorders characterized by uteroplacental dysfunction in a multi-ethnic population, aiming to improve the identification of women at high risk for uteroplacental dysfunction using current prediction models.
Study Design:
We conducted a linkage study combining lipid profile collected in the multi-ethnic HELIUS study (Amsterdam, 2011-2015), linked with national perinatal registry data on pregnancy complications after inclusion until 2019. We included 1177 women of Dutch, South-Asian Surinamese, African Surinamese, Ghanaian, Turkish, and Moroccan origin. Associations were studied using Poisson regression. The discriminative ability was assessed for different pregnancy complications of significantly associated lipid parameters when added to commonly used prediction tools for preeclampsia.
Results:
Preconception triglyceride level was associated with prevalence of hypertensive disorders of pregnancy (e^triglyceride level (mmol/L) adjusted prevalence ratio 1.07, 95% CI 1.00 to 1.14). Age-adjusted prevalence of hypertensive disorders of pregnancy was also higher among women with high LDL-C level, high TC/HDL-C or ≥4 adverse lipid parameters, but most of these findings were not statistically significant when adjusted for demographic, lifestyle and medical characteristics. Addition of triglyceride level and other lipid parameters to the NICE guideline criteria and to the EXPECT prediction tool did not improve discriminative ability for hypertensive disorders of pregnancy, preterm birth or fetal growth restriction.
Conclusion(S):
Lipid profile did not aid in the identification of women at high risk for pregnancy disorders characterized by uteroplacental dysfunction. Further studies are needed to improve preconception prediction models for hypertensive disorders of pregnancy and other pregnancy disorders characterized by uteroplacental dysfunction using biomarkers or other easily available measurements.
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