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Archives of Gynecology and Obstetrics
Published in: Archives of Gynecology and Obstetrics 6/2019

01-12-2019 | Maternal-Fetal Medicine

Reference intervals of serum lipids in the second and third trimesters of pregnancy in a Caucasian cohort: the LIFE Child study

Authors: Anne Dathan-Stumpf, Mandy Vogel, Alexander Jank, Joachim Thiery, Wieland Kiess, Holger Stepan

Published in: Archives of Gynecology and Obstetrics | Issue 6/2019

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Abstract

Background

The study aimed to establish reference intervals for serum lipids and apolipoproteins in pregnant women depending on trimester and parity, and to investigate the influence of various factors on lipid and apolipoprotein concentrations.

Materials and methods

A total of 748 pregnant women (n = 683 in the second trimester, n = 676 in the third trimester) were included in the study and reference intervals for total cholesterol (TC), HDL, LDL, triglycerides (TG), apoA1 and apoB were determined as empirical quantiles. The measurement of serum lipids was performed using a validated specific homozygous enzymatic color test. Hierarchical models were used to investigate hypothesized relations.

Results

Except for apoA1, all serum lipids levels showed a significant change from the second to the third trimester. This increase was most pronounced for TGs. Especially in the third trimester, the concentrations of serum lipids exceeded the currently accepted reference values for non-pregnant women by a factor of 2.5. Reference intervals of serum lipids at the second and third trimesters in healthy pregnant women were as following: TC 4.45–8.99 and 4.83–9.71 mmol/l, HDL 1.33–3.06 and 1.16–3.13 mmol/l, LDL 2.14–6.11 and 2.35–6.98 mmol/l, TG 0.92–3.0 and 1.37–4.76 mmol/l as well as apoB 0.69–1.93 and 0.85–2.21 g/l. Parity and nutrient intake were not significantly associated with changes in lipid concentration. Prematurity was associated with a significant decrease in TC and TG levels.

Conclusion

Detailed reference values for serum lipids and apolipoproteins in pregnancy are now available for a Caucasian cohort. Further, long-term studies are still needed to assess the effect of the extensive concentration changes of serum lipids in pregnancy and their atherogenic risk definitively.
Literature
1.
Richter-Kuhlmann E (2012) Gesundheitssurvey des Robert-Koch-Instituts: zivilisationskrankheiten nehmen zu. Deutsch Ärztebl 109(26):1376–1377
2.
Mensink GBM, Schienkiewitz A, Haftenberger M et al (2013) Übergewicht und Adipositas in Deutschland Ergebnisse der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1). Bundesgesundheitsbl 56:786–794CrossRef
3.
4.
Roloff R (2007) Die Prävalenz von Übergewicht und Adipositas bei Schwangeren und ihr geburthilfliches Ergebnis zwischen 1980 und 2005 im Vergleich an der Univeristäts-Frauenklinik Würzburg, Würzburg
5.
Dathan-Stumpf A, Vogel M, Rieger K et al (2016) Serum lipid levels were related to socio-demographic characteristics in a German population-based child cohort. Acta Paediatr 105(8):e360–e367CrossRef
6.
Knopp RH, Warth MR, Charles D et al (1986) Lipoprotein metabolism in pregnancy, fat transport to the fetus, and the effects of diabetes. Biol Neonate 50(6):297–317CrossRef
7.
Aguilar Cordero MJ, Baena García L, Sánchez López AM et al (2015) Triglyceride levels as a risk factor during pregnancy; biological modeling; systematic review. Nutr Hosp 32(2):517–527PubMed
8.
Sidhwani S, Scoccia B, Sunghay S et al (2011) Polycystic ovary syndrome is associated with atherogenic changes in lipoprotein particle number and size independent of body weight. Clin Endocrinol (Oxf) 75(1):76–82CrossRef
9.
Lippi G, Albiero A, Montagnana M et al (2007) Lipid and lipoprotein profile in physiological pregnancy. Clin Lab 53(3–4):173–177PubMed
10.
Ferriols E, Rueda C, Gamero R et al (2016) Relationship between lipid alterations during pregnancy and adverse pregnancy outcomes. Clin Investig Arterioscler. 28(5):232–244PubMed
11.
Ghodke B, Pusukuru R, Mehta V (2017) Association of lipid profile in pregnancy with preeclampsia, gestational diabetes mellitus, and preterm delivery. Cureus 9(7):e1420PubMedPubMedCentral
12.
Vrijkotte TG, Krukziener N, Hutten BA et al (2012) Maternal lipid profile during early pregnancy and pregnancy complications and outcomes: the ABCD study. J Clin Endocrinol Metab 97(11):3917–3925CrossRef
13.
Gratacós E, Casals E, Sanllehy C et al (1996) Variation in lipid levels during pregnancy in women with different types of hypertension. Acta Obstet Gynecol Scand 75(10):896–901CrossRef
14.
Gallos ID, Sivakumar K, Kilby MD et al (2013) Pre-eclampsia is associated with, and preceded by, hypertriglyceridaemia: a meta-analysis. BJOG 120(11):1321–1332CrossRef
15.
Bayhan G, Koçyigit Y, Atamer A et al (2005) Potential atherogenic roles of lipids, lipoprotein (a) and lipid peroxidation in preeclampsia. Gynecol Endocrinol 21(1):1–6CrossRef
16.
Nikolov A, Dimitrov A, Liubomirova M et al (2002) Lipid metabolism and its changes in pregnancy. Akush Ginekol (Sofiia) 41(4):30–34
17.
Deslypere JP, Van Trappen Y, Thiery M (1990) Influence of parity on plasma lipid levels. Eur J Obstet Gynecol Reprod Biol 35(1):1–6CrossRef
18.
Pecks U, Rath W, Kleine-Eggebrecht N et al (2016) Maternal serum lipid, estradiol, and progesterone levels in pregnancy, and the impact of placental and hepatic pathologies. Geburtshilfe Frauenheilkd 76(7):799–808CrossRef
19.
Makieva S, Saunders PT, Norman JE (2014) Androgens in pregnancy: roles in parturition. Hum Reprod Update 20(4):542–559CrossRef
20.
Quante M, Hesse M, Döhnert M et al (2012) The LIFE child study: a life course approach to disease and health. BMC Public Health 12:1021CrossRef
21.
22.
Poulain T, Baber R, Vogel M et al (2017) The LIFE Child study: a population-based perinatal and pediatric cohort in Germany. Eur J Epidemiol 32(2):145–158CrossRef
23.
Schneider H, Husslein P (2006) Schneider KTM Die Geburtshilfe. 3.Auflage, vol 185. Springer, BerlinCrossRef
24.
Heinrich J, Brüske I, Schnappinger M et al (2012) Die zwei deutschen Geburtskohorten GINIplus und LISAplus [Two German birth cohorts: gINIplus and LISAplus]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 55:864–874CrossRef
25.
von Berg A, Krämer U, Link E et al (2010) Impact of early feeding on childhood eczema: development after nutritional intervention compared with the natural course—the GINIplus study up to the age of 6 years. Clin Exp Allergy 40:627–636PubMed
26.
Stiegler P, Sausenthaler S, Buyken AE et al (2010) A new FFQ designed to measure the intake of fatty acids and antioxidants in children. Public Health Nutr 13(1):38–46CrossRef
27.
28.
29.
Johnson JL, Slentz CA, Duscha BD et al (2004) Gender and racial differences in lipoprotein subclass distributions: the STRRIDE study. Atherosclerosis 176(2):371–377CrossRef
30.
Miljkovic-Gacic I, Bunker CH, Ferrell RE et al (2006) Lipoprotein subclass and particle size differences in Afro-Caribbeans, African Americans, and white Americans: associations with hepatic lipase gene variation. Metabolism 55(1):96–102CrossRef
31.
Piechota WSA (1992) Reference ranges of lipids and apolipoproteins in pregnancy. Eur J Obstet Gynecol Reprod Biol 45(1):27–35CrossRef
32.
Chen QJ, Lai HM, Chen BD et al (2016) Appropriate LDL-C-to-HDL-c ratio cutoffs for categorization of cardiovascular disease risk factors among Uygur Adults in Xinjiang, China. Int J Environ Res Public Health 13(2):235CrossRef
33.
Millán J, Pintó X, Muñoz A et al (2009) Lipoprotein ratios: physiological significance and clinical usefulness in cardiovascular prevention. Vasc Health Risk Manag 5:757–765PubMedPubMedCentral
34.
Ying C, Yue C, Zhang C et al (2015) Analysis of serum lipids levels and the establishment of reference intervals for serum lipids in middle and late pregnancy. Zhonghua Fu Chan Ke Za Zhi 50(12):926–930PubMed
35.
Pusukuru R, Shenoi AS, Kyada PK et al (2016) Evaluation of lipid profile in second and third trimester of pregnancy. J Clin Diagn Res 10(3):QC12-6PubMed
36.
Pecks U, Rath W, Caspers R et al (2013) Oxidatively modified LDL particles in the human placenta in early and late onset intrauterine growth restriction. Placenta 34(12):1142–1149CrossRef
37.
Heller A (1998) Geburtsvorbereitung methode Menner-Heller. Georg Thieme Verlag, Stuttgart
38.
Emet T, Ustüner I, Güven SG et al (2013) Plasma lipids and lipoproteins during pregnancy and related pregnancy outcomes. Arch Gynecol Obstet 288(1):49–55CrossRef
39.
Jiang S, Jiang J, Xu H et al (2017) Maternal dyslipidemia during pregnancy may increase the risk of preterm birth: a meta-analysis. Taiwan J Obstet Gynecol 56(1):9–15CrossRef
40.
41.
Gruchot M, Gräter T, Kratzer W et al (2013) Einfluss der Nüchternzeit auf verschiedene Lipidwerte in Korrelation zu einer bestehenden Steatosis hepatis—Eine bevölkerungsstichprobe an 2445 Probanden. Z Gastroenterol 51:K286CrossRef
Metadata
Title
Reference intervals of serum lipids in the second and third trimesters of pregnancy in a Caucasian cohort: the LIFE Child study
Authors
Anne Dathan-Stumpf
Mandy Vogel
Alexander Jank
Joachim Thiery
Wieland Kiess
Holger Stepan
Publication date
01-12-2019
Publisher
Springer Berlin Heidelberg
Published in
Archives of Gynecology and Obstetrics / Issue 6/2019
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-019-05342-2

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