DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20200685

Third trimester maternal blood and at birth cord blood lipid profile characteristics in pregnant woman with or without fetal growth restriction

Swati Nayan, Mohan Meena, Lata Rajoria, Nupur Hooja, Sunil Gothwal, Andleeb Fatima, B. S. Meena, Ghan Shyam Bairwa, Priyanka Meena, Rajni Nawal, Megha Sharma

Abstract


Background: To study the lipid profile of 3rd trimester pregnant women and their cord blood with and without intrauterine growth restriction Design: Observational study, Setting: Department of Obstetrics and Neonatology, in a teaching hospital in North India during February 2013 to August 2014.

Methods: Third trimester pregnant women and their neonates. Enrolled 250 women were divided in intrauterine growth restricted and control groups. Outcome Measures: Venous blood Lipid levels of 3rd trimester mothers and their neonate at birth.

Results: Women of IUGR group had significantly lowered total cholesterol (TC), triglycerides (TG), high density lipoproteins (HDL) and low density lipoproteins (LDL)210.2 (19.8), 221.6 (36.2),65.4(11.7)and 130.7 (20.8)compared to 251(55.3), 234.7(35.6), 70.8(19.9) and 181.3(16.8) mg/dl control group. The TC, TG and LDL levels in cord blood of IUGR group were 93.6(16.5), 50.4 (6.5) and 51.8(12.6) as compared 106.4(17.7), 30.7(4.4) and 55.9(12.1) mg/dl to control group (p value <0.05). HDL levels were significantly lower 15.8(4.6) in IUGR group as compared to 26.5(5.4) in control group. The LDL: HDL and TC: HDL ratio was significantly higher in IUGR group. Maternal weight, gestational age, urban residence, primi parity, birth weight and APGAR score were lower, while maternal age, parity, smoking, blood pressure, cesarean sections (%) and male sex (%) of baby was higher in IUGR group.

Conclusions: Lipid profile of mothers of IUGR fetuses had significantly lowered cholesterol levels and their cord blood had shown atherogenic phenotype


Keywords


Intrauterine growth restriction, Lipid profile, Neonates, Pregnancy, 3rd trimester pregnancy

Full Text:

PDF

References


Villar J, Merialdi M, Gulmezoglu AM, Abalos E, Carroli G, Kulier R, et al. Nutritional interventions during pregnancy for the prevention or treatment of maternal morbidity and preterm delivery: an overview of randomized controlled trials. J Nutr. 2003 May 1;133(5):1606S-25S.

Burke KT, Colvin PL, Myatt L, Graf GA, Schroeder F, Woollett LA. Transport of maternal cholesterol to the fetus is affected by maternal plasma cholesterol concentrations in the golden Syrian hamster. J Lipid Res. 2009;50:1146-55.

Elizabeth KE, Krishnan V, Vijayakumar T. Umbilical cord blood nutrients in low birth weight babies in relation to birth weight and gestational age. Indian J Med Res. 2008;128:128-33.

Pecks U, Caspers R, Schiessl B, Bauerschlag D, Piroth D, Maass N, et al. The evaluation of the oxidative state of lowdensity lipoproteins in intrauterine growth restriction and preeclampsia. Hypertens Pregnancy. 2011

Nayak CD, Agarwal V, Nayak DM. Correlation of cord blood lipid heterogeneity in neonates with their anthropometry at birth. Ind J Clini Biochem. 2013 Apr 1;28(2):152-7.

Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clini Chem. 1972 Jun 1;18(6):499-502.

Cetin I, Alvino G, Cardellicchio M. Long chain fatty acids and dietary fats in fetal nutrition. J Physiol. 2009 Jul 15;587(14):3441-51.

Herrera E. Lipid metabolism in pregnancy and its consequences in the fetus and newborn. Endo. 2002 Oct; 19(1):43-55.

Dabi DR, Parakh M, Goyal V. A cross sectional study of lipids and lipoproteins in pregnancies with intrauterine growth retardation. J obestetgynecol Ind. 2004;54(5):467-72.

Kaser S, Ebenbichler CF, Wolf HJ, Sandhofer A, Stanzl U, Ritsch A, et al. Lipoprotein profi le and cholesteryl ester transfer protein in neonates. Metab. 2001;50:723-8.

Palinski W. Maternal-fetal cholesterol transport in the placenta: good, bad and target for modulation. Circ Res. 2009;104:569-71.

Huppertz B. Placental origins of preeclampsia: challenging the current hypothesis. Hypertension. 2008;51:970-5.

Villar J, Carroli G, Wojdyla D, Abalos E, Giordano D, Ba ' aqeel H, et al. Preeclampsia, gestational hypertension and intrauterine growth restriction, related or independent conditions? Am J Obstet Gynecol. 2006;194:921-31.

Burton GJ, Yung HW, Cindrova-Davies T, Charnock-Jones DS. Placental endoplasmic reticulum stress and oxidative stress in the pathophysiology of unexplained intrauterine growth restriction and early onset preeclampsia. Placenta. 2009;30:S43-8.

Wadsack C, Tabano S, Maier A, Hiden U, Alvino G, Cozzi V, et al. Intrauterine growth restriction is associated with alterations in placental lipoprotein receptors and maternal lipoprotein composition. Am J Physiol Endocrinol Metab. 2007;292:E476-84.

National High Blood Pressure Education Program Working Group. Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. Am J Obstet Gynecol. 2000;183:S1-S22.

Navab M, Reddy ST, Van Lenten BJ, Fogelman AM. HDL and cardiovascular disease: atherogenic and atheroprotective mechanisms. Nat Rev Cardiol. 2011;8:222-32.

Barker DJ. Fetal origins of coronary heart disease. Br Med J. 1995;311:171-4.

Leduc L, Levy E, Bouity-Voubou M, Delvin E. Fetal programming of atherosclerosis: possible role of the mitochondria. Eur J Obstet Gynecol Reprod Biol. 2010;149:127-30.

Palinski W. Maternal-fetal cholesterol transport in the placenta: good, bad and target for modulation. Circ Res. 2009;104:569-71.

Skilton MR. Intrauterine risk factors for precocious atherosclerosis. Pediatr. 2008;121:570-4.

VA Rodie, MJ Caslake, F Stewart, N Sattar, JE Ramsay, IA Greer, et al. Fetal cord plasma lipoprotein status in uncomplicated human pregnancies and in pregnancies complicated by pre-eclampsia and intrauterine growth restriction. Atheroscler. 2004;176:181-7.

Hajek Z, Drbohlav P, Ceska R, HorĂ­nek A, Fiedler J. The spectrum of lipids in the intrauterine growth retarded fetus and in the parents; Ceska Gynekol. 2000 May;65(3):123-7.

Lane DM, McConathy WJ. Factors affecting the lipid and apolipoprotein levels of cord sera. Pediatr Res. 1983;17:83-91.

Diaz M, Leal C, Ramon y Cajal J, Jimenez MD, Martinez H, Pocovi M, et al. Cord blood lipoprotein-cholesterol: relationship birth weight and gestational age of newborns. Metab.1989;38:435-8.

Spencer JA, Chang TC, Crook D, Proudler A, Felton CV, Robson SC, et al. Third trimester fetal growth and measures of carbohydrate and lipid metabolism in umbilical venous blood at term. Arch Dis Child Fetal Neonatal Ed. 1997;76:F21-5.