title: Deviant early pregnancy maternal triglyceride levels and increased risk of congenital anomalies: a prospective community-based cohort study.
abstract: OBJECTIVE
  The maternal lipid profile could be of importance in congenital anomaly development. This study therefore investigates whether the maternal lipid profile during early pregnancy is associated with major nonsyndromic congenital anomalies (MNCA).
  
  
  METHODS
  Prospective community-based cohort study.
  
  
  METHODS
  Amsterdam Born Children and their Development (ABCD) study.
  
  
  METHODS
  A cohort of 3074 pregnant women recruited in 2003-2004 and their offspring.
  
  
  METHODS
  Non-fasting blood samples from pregnant women participating in the ABCD-study (median 12.9 weeks of gestation) were analysed for triglycerides (TG), cholesterol (TC), free fatty acids (FFA), apolipoprotein B (ApoB), and apolipoprotein A1 (ApoA) (n = 3074). The perinatal outcome (MNCA) was obtained from the Youth Health Care Registration and two questionnaires. Adjustment was made for ethnicity.
  
  
  METHODS
  MNCA prevalence.
  
  
  RESULTS
  The prevalence of MNCA was 2.2% (n = 68: 20 cardiovascular, 25 bone and muscle, and 23 other single anomalies). A nonlinear association was found between maternal TG levels and MNCA prevalence. With a lower or higher level of maternal TG, the estimated probability increased: a TG level of 0.73 mmol/l (5th percentile), of 1.28 mmol/l (50th percentile), and of 2.35 mmol/l (95th percentile) corresponded with an estimated probability of 3.6, 2.1, and 2.9%, respectively. Unadjusted subgroup analyses showed that the U-shaped association was most prominent for cardiovascular congenital anomalies. Other lipids were not associated with MNCA.
  
  
  CONCLUSIONS
  Both low and high maternal TG levels during early pregnancy were associated with an increased risk of MNCA in offspring. This suggests that an attempt should be made to normalise TG levels before or during early pregnancy; however, replication of our results is necessary before clinical practice recommendations can be made.
authors: Department of Public Health, Academic Medical Centre - University of Amsterdam, Amsterdam, the Netherlands.
authors: M
authors: M
authors: Nederlof
authors: Department of Genetics, University of Groningen, University Medical Centre Groningen, Eurocat Registration Northern Netherlands, Groningen, the Netherlands.
authors: H E K
authors: HE
authors: de Walle
authors: Department of Public and Occupational Health, EMGO Institute - VU University Medical Centre, Amsterdam, the Netherlands.
authors: M N M
authors: MN
authors: van Poppel
authors: Department of Public Health, Academic Medical Centre - University of Amsterdam, Amsterdam, the Netherlands.
authors: T G M
authors: TG
authors: Vrijkotte
authors: Department of Public Health, Academic Medical Centre - University of Amsterdam, Amsterdam, the Netherlands.
authors: M G J
authors: MG
authors: Gademan
mesh_terms: D000328:Adult; D001724:Birth Weight; D015992:Body Mass Index; D000013:Congenital Abnormalities / Q000097:blood* / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008055:Lipids / Q000097:blood; D009035:Mothers; D009426:Netherlands / Q000453:epidemiology; D011247:Pregnancy; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014280:Triglycerides / Q000097:blood*
chemical_list: D008055:Lipids; D014280:Triglycerides
keywords: Congenital anomalies; early pregnancy; maternal lipids; triglycerides