Cord blood lipoproteins and prenatal influences.
OBJECTIVE
Blood lipoprotein profiles in early life are known to be related to and predictive of those in adulthood, but little is known about their determinants. Genetic and environmental influences affect cord blood lipoproteins, but how this occurs and the relative contribution of these influences to the overall profile in healthy newborns remains uncertain.


RESULTS
This review discusses findings from a range of earlier and more recent studies, and summarizes the key influences on cord blood lipoproteins. In particular, we review the potential contribution of maternal blood total cholesterol levels during pregnancy and the increased maternal transmission in newborns of mothers with diabetes.


CONCLUSIONS
In cord blood, cholesterol levels are lower than in adults and the relative proportion present in HDL as opposed to LDL is much higher. The currently available evidence suggests that several factors influence the composition of cord blood lipoproteins. Although inheritance of major monogenic disorders can affect cord lipids in general, the genetic contribution appears to be minimal, although effects of the proprotein convertase subtilisin/kexine type 9 gene (PCSK9) need fuller exploration in this regard in certain ethnic groups. Evidence is summarized that maternal lipoprotein levels, particularly those due to diet or induced by pregnancy, influence cord lipid levels. Placental insufficiency and other conditions affecting fetal growth and the mode of delivery may also influence cord lipoprotein concentrations. How maternal glucose tolerance during pregnancy affects cord blood lipoproteins remains unclear. In view of increasing evidence that cardiovascular risk may have prenatal antecedents, this would seem to be an important area for further investigation.
Clinical Epidemiology & Cardiovascular Medicine Group, Division of Cardiovascular and Endocrine Science, University Department of Medicine, Manchester Royal Infirmary, UK. n.bansal@postgrad.man.ac.uk
Narinder
N
Bansal
J Kennedy
JK
Cruickshank
Patrick
P
McElduff
Paul N
PN
Durrington
D002784:Cholesterol / Q000097:blood; D004032:Diet; D005260:Female; D005312:Fetal Blood / Q000378:metabolism*; D006801:Humans; D007231:Infant, Newborn; D008074:Lipoproteins / Q000097:blood*; D008431:Maternal-Fetal Exchange; D011247:Pregnancy; D014280:Triglycerides / Q000097:blood
D008074:Lipoproteins; D014280:Triglycerides; D002784:Cholesterol