Maternal mid-pregnancy lipids and birthweight

ObjectiveTo describe associations between maternal lipids and birthweight and to determine whether pre-pregnancy body mass index (BMI) modifies these associations. DesignCohort study. SettingMultiple communities in Michigan, USA. PopulationParticipants were a sub-cohort of women from the multi-community Pregnancy Outcomes and Community Health (POUCH) study (1998-2004). MethodsMaternal total cholesterol, high-density lipoprotein (HDLc), and low-density lipoprotein (LDLc) cholesterol, and triglycerides were assessed at 16-27weeks' gestation. Women were classified as having normal (<25kg/m(2)) or overweight/obese (25kg/m(2)) pre-pregnancy BMI. Main outcome measuresSex- and gestational-age-specific body weight z-score (BWz). ResultsRegression models examined associations among lipids (low: 1st quartile, referent: middle quartiles, high: 4th quartile) and BWz for the total sample and stratified by pre-pregnancy BMI. In adjusted analyses (n=1207), low HDLc was associated with lower BWz (=-0.23, 95% CI -0.40 to -0.06), whereas high triglycerides were associated with higher BWz (=0.23, 95% CI 0.06-0.41). Once stratified by pre-pregnancy BMI, low total cholesterol was associated with lower BWz in normal BMI women (=-0.25, 95% CI -0.47 to -0.03), whereas in overweight/obese BMI women, high HDLc was inversely (=-0.29, 95% CI -0.54 to -0.04) and high triglycerides were directly associated with BWz (=0.32, 95% CI 0.07-0.54). Removing women with gestational diabetes/hypertensive disorders did not alter the results. ConclusionsThe associations between maternal lipids and BWz vary by lipid measure and pre-pregnancy BMI. Future work should examine whether lipids and pre-pregnancy BMI make unique contributions to the fetal programming of disease.