title: Maternal lipid profile during early pregnancy and pregnancy complications and outcomes: the ABCD study.
abstract: BACKGROUND
  Elevated lipid levels during late pregnancy are associated with complications and adverse outcome for both mother and newborn. However, it is inconclusive whether a disturbed lipid profile during early pregnancy has similar negative associations.
  
  
  OBJECTIVE
  Our objective was to investigate whether nonfasting maternal total cholesterol and triglyceride levels during early pregnancy are associated with six major adverse pregnancy outcomes.
  
  
  METHODS
  Data were derived from the Amsterdam Born Children and Their Development (ABCD) cohort study. Random blood samples of nonfasting total cholesterol and triglyceride levels were determined during early gestation (median = 13, interquartile range = 12-14 wk). Outcome measures were pregnancy-induced hypertension (PIH), preeclampsia, preterm birth, small/large for gestational age (SGA/LGA), and child loss. Only nondiabetic women with singleton deliveries were included; the baseline sample consisted of 4008 women. Analysis for PIH and preeclampsia were performed in nulliparous women only (n = 2037).
  
  
  RESULTS
  Mean (sd) triglyceride and total cholesterol levels were 1.33 (0.55) and 4.98 (0.87) mmol/liter, respectively. The incidence of pregnancy complications and perinatal outcomes were as follows: PIH, 4.9%; preeclampsia, 3.7%; preterm birth, 5.3%; SGA, 9.3%; LGA, 9.3%; and child loss, 1.4%. After adjustments, every unit increase in triglycerides was linearly associated with an increased risk of PIH [odds ratio (OR) = 1.60, P = 0.021], preeclampsia (OR = 1.69, P = 0.018), LGA (OR = 1.48, P < 0.001), and induced preterm delivery (OR = 1.69, P = 0.006). No associations were found for SGA or child loss. Total cholesterol was not associated with any of the outcome measures.
  
  
  CONCLUSIONS
  Elevated maternal triglyceride levels measured during early pregnancy are associated with pregnancy complications and adverse pregnancy outcomes. These results suggest that future lifestyle programs in women of reproductive age with a focus on lowering triglyceride levels (i.e. diet, weight reduction, and physical activity) may help to prevent hypertensive complications during pregnancy and adverse birth outcomes.
authors.affiliation: Department of Public Health, Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands. T.Vrijkotte@amc.uva.nl
authors.forename: Tanja G M
authors.initials: TG
authors.lastname: Vrijkotte
authors.forename: Náthalie
authors.initials: N
authors.lastname: Krukziener
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Hutten
authors.forename: Karlijn C
authors.initials: KC
authors.lastname: Vollebregt
authors.forename: Manon
authors.initials: M
authors.lastname: van Eijsden
authors.forename: Marcel B
authors.initials: MB
authors.lastname: Twickler
mesh_terms: D000328:Adult; D002784:Cholesterol / Q000097:blood*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood*; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First / Q000097:blood*; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D014280:Triglycerides / Q000097:blood*
chemical_list: D014280:Triglycerides; D002784:Cholesterol