Early pregnancy maternal lipid profile, acute phase responders, and the association with preterm delivery and selected pregnancy outcomes

Abstract Introduction It is estimated that 30%–50% of spontaneous preterm deliveries (PTDs) are caused by infectious states. Acute‐phase responders (APRs) accompany chronic as well as acute inflammatory states. In addition, hyperlipidemia is considered as a precursor of inflammation and oxidative stress. This study aimed to examine the associations between maternal serum levels of lipids and APRs in the 1st trimester of pregnancy and pregnancy outcomes. Methods A prospective cohort study was conducted among multipara individuals with singleton pregnancies. Recruitment took place between 11 and 13 gestational weeks. The exposures were serum levels of the following APRs: C‐ reactive protein, albumin, triglyceride, total cholesterol, low density lipoprotein calculated (LDL‐c), and high density lipoprotein. The outcomes were gestational diabetes mellitus, preeclampsia, gestational age at delivery, PTD (< 37 gestational weeks + 0 days), low birthweight, and macrosomia. Participants with the lowest or highest levels for each APR were identified based on clinical cut points. Multivariable analyses were performed to evaluate the independent association between the APRs and the studied outcomes, including linear models for gestational age at delivery or birthweight, and logistic models for PTD and other outcomes. Result A total of 201 participants were included in the study. Mean birthweight was higher among individuals with high total cholesterol (3392.710 ± 426 g vs. 3220.782 ± 448 g, p value = 0.01). Similarly, mean birthweight was higher among individuals with high LDL‐c (3414.520 ± 407 g vs. 3237.324 ± 453 g, p value = 0.018). In multivariable linear models for the association between total cholesterol or LDL‐c and birthweight, which adjusted for newborn sex, gestational age at delivery, gestational diabetes mellitus or pregestational diabetes mellitus, and maternal body mass index (BMI), an increase in one unit of total cholesterol was significantly related with higher birthweight (2.796 g per unit, 95% CI = 0.682–3.956), and an increase in one unit of LDL‐c was significantly related with higher birthweight (2.463 g per unit, 95% CI = 0.152–4.773). No associations were found between early pregnancy APRs and PTD, gestational age at delivery, and the other outcomes of interest. Conclusions Higher birthweight was found among individuals with high early pregnancy total cholesterol and LDL‐c levels, even after controlling for maternal BMI. Early monitoring of maternal lipid profile may serve as a useful predictor of excessive fetal growth, providing a potential tool for identifying pregnancies and individuals at higher risk for this complication, and which could benefit from closer observation. Levels of APRs were not associated with other pregnancy outcomes of interest.