Association of elevated free fatty acids during late pregnancy with preterm delivery.
OBJECTIVE
To examine the association between moderately elevated maternal plasma free fatty acids (FFAs) during late pregnancy and preterm delivery.


METHODS
In a prospective observational cohort with 523 healthy pregnant women, fasting plasma FFAs were measured during the third trimester. Socioeconomic, demographic, and anthropometric measures were collected at entry to prenatal care, and pregnancy outcomes were abstracted from medical record at delivery.


RESULTS
After control for confounders including prepregnant body mass index (multiple logistic regression analysis), women who had moderately elevated plasma FFAs (in the highest tertile), showed a greater than threefold increased risk of preterm delivery (adjusted odds ratio (AOR) 3.49, 95% (CI) 1.73-7.03, P<.001). The associations persisted in women who had spontaneous preterm delivery (AOR 2.35, 95% CI 1.05-5.28, P<.05) and after excluding women with gestational diabetes mellitus and preeclampsia (AOR 3.30, 95% CI 1.38-7.87, P<.01). Additional stratified analyses showed that the association of high maternal FFAs and increased risk of preterm delivery was independent of prepregnant obesity.


CONCLUSIONS
Elevated fasting plasma FFA levels at 30 weeks of gestation were associated with an increased risk of preterm delivery. This effect was independent of prepregnant obesity and several other known risk factors for preterm delivery, including cigarette smoking, ethnicity, and prior preterm delivery. These data may have important clinical significance because they provide a possible link between preterm delivery and high lipid levels, a known risk factor for cardiovascular disease.
Chen
Xinhua
X
Department of Obstetrics and Gynecology, University of Medicine and Dentistry of New Jersey-School of Osteopathic Medicine, Stratford, New Jersey, USA.
Scholl
Theresa O
TO
D000328:Adult; D015992:Body Mass Index; D005230:Fatty Acids, Nonesterified / Q000097:blood*; D005260:Female; D006801:Humans; D016015:Logistic Models; D016017:Odds Ratio; D011247:Pregnancy; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third / Q000097:blood*; D047928:Premature Birth / Q000097:blood* / Q000453:epidemiology / Q000503:physiopathology; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology
D005230:Fatty Acids, Nonesterified