The Association Of Maternal Serum Lipid Levels During Late Pregnancy With Preterm Births

Objective: To examine the association between maternal serum lipids levels in the plasma during late pregnancy and preterm birth,we can prevent spontaneous preterm birth and reduce the adverse metabolic risk of the fetus and its mother in the long run.Methods: We selected the 2612 pregnant women for analysis from January 1,2016 to December 31,2016 in Shanghai General Hospital,School of Medicine,Shanghai Jiao Tong University which includes five groups including all cases of preterm pathological pregnancy(n = 68)and preterm birth(total n = 139;referring to preterm without pathological pregnancy);pathological pregnancies at term(n = 370);all pathological pregnancies(total n=438;including preterm pathological pregnancy [n=68] and pathological pregnancy at term [n=370])and controls(n = 2033).Pathological pregnancy refers pregnant women with preeclampsia and / or gestational diabetes mellitus.Then,total cholesterol,triglyceride(TG),high-density lipoprotein cholesterol,low-density lipoprotein cholesterol and free fatty acids(FFA)were measured from fasting venous blood samples.Results: After controlling for confounding factors,including pre-pregnancy body mass index(BMI)and maternal age,FFA concentrations measured during late pregnancy were associated with a significantly increased(by a factor of 3.78)risk of preterm pathological pregnancy group(95% confidence interval [CI]:1.44-9.93,P = 0.007)and increased(by a factor of 2.87)risk of preterm birth group(95% confidence interval [CI]:1.50-5.49,P=0.001).Furthermore,TG showed a negative association with preterm birth group(adjusted odds ratio [OR] = 0.85,CI:0.72-0.99,P < 0.05).The ratio of FFA / TG in preterm birth group was higher than that in control group(P <0.001).The TG level of maternal serum male fetus was higher than that of females(3.80 ± 2.21 mmol/L vs 3.36 ± 1.50 mmol/L,P< 0.05)? Conclusion: FFA levels show strong relationships with preterm birth and elevated maternal TG levels may act in a protective capacity for preterm delivery.Lipid metabolism in preterm pregnant women showed a state of disorder.Furthermore,fetal gender differences may affect maternal lipid metabolism.