title: Maternal Circulating Lipid Profile during Early Pregnancy: Racial/Ethnic Differences and Association with Spontaneous Preterm Delivery.
abstract: Prior reports on the association between altered maternal serum lipid levels with preterm delivery are inconsistent. Ethnic differences in serum lipids during pregnancy and their relation to preterm delivery have not been studied. We examined the relationships of six maternal lipids during early pregnancy with the risk of spontaneous preterm delivery (SPTD). The design represents a case-control study nested within a large prospective, multiethnic cohort of young, generally healthy pregnant women. SPTD cases (n= 183) and controls who delivered at term (n= 376) were included. SPTD is defined as delivery at <37 completed weeks of gestation without indicated conditions. We found that African-American women had significantly increased levels of high-density lipoprotein cholesterol (HDL-C) and apolipoprotein A1 (apoA1), and lower triglyceride (TG) and apolipoprotein B (apoB) levels compared to Hispanic and non-Hispanic Caucasians combined. Elevated HDL-C and apoA1 concentrations were significantly associated with an increased odds of SPTD after controlling for potential confounding factors. The adjusted odds ratio (AOR) was 1.91 (95% confidence interval (CI) 1.15, 3.20) for the highest quartile of HDL-C relative to the lowest quartile, and for apoA1 the AOR was 1.94 (95% CI 1.16, 3.24). When controlling for ethnicity, the results remained comparable. These data suggest that pregnant African-American women had a more favorable lipid profile suggestive of a reduction in cardiovascular risk. Despite this, increased HDL-C and apoA1 were both found to be associated with SPTD.
authors.affiliation: Department of Obstetrics/Gynecology, School of Osteopathic Medicine, Rowan University, Stratford, NJ 08084, USA. chenx1@rowan.edu.
authors.forename: Xinhua
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Obstetrics/Gynecology, School of Osteopathic Medicine, Rowan University, Stratford, NJ 08084, USA. schollto@rowan.edu.
authors.forename: Theresa O
authors.initials: TO
authors.lastname: Scholl
authors.affiliation: Department of Surgery, School of Osteopathic Medicine, Rowan University, Stratford, NJ 08084, USA. tpstein@rowan.edu.
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Stein
authors.affiliation: Department of Psychiatry, School of Osteopathic Medicine, Rowan University, Stratford, NJ 08084, USA. steer@rowan.edu.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Steer
authors.affiliation: Department of Obstetrics/Gynecology, School of Osteopathic Medicine, Rowan University, Stratford, NJ 08084, USA. williakp@rowan.edu.
authors.forename: Keith P
authors.initials: KP
authors.lastname: Williams
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D016632:Apolipoprotein A-I / Q000097:blood; D001055:Apolipoproteins B / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000097:blood / Q000208:ethnology; D016022:Case-Control Studies; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood*; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D011247:Pregnancy; D047928:Premature Birth / Q000097:blood* / Q000208:ethnology*; D011446:Prospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D014280:Triglycerides / Q000097:blood*; D044465:White People; D055815:Young Adult
chemical_list: D016632:Apolipoprotein A-I; D001055:Apolipoproteins B; D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides
keywords: apolipoprotein A1; high-density lipoprotein cholesterol; racial/ethnic disparity; serum lipid levels; spontaneous preterm delivery