Am J Perinatol 2017; 34(13): 1326-1332
DOI: 10.1055/s-0037-1603471
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Lipoprotein Heterogeneity Early in Pregnancy and Preterm Birth

Janet M. Catov
1   Department of Obstetrics, Gynecology and Reproductive Sciences, Magee Women's Research Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
2   Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania
,
Rachel H. Mackey
2   Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania
,
Christina M. Scifres*
1   Department of Obstetrics, Gynecology and Reproductive Sciences, Magee Women's Research Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
,
Marnie Bertolet
2   Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania
,
Hyagriv N. Simhan
1   Department of Obstetrics, Gynecology and Reproductive Sciences, Magee Women's Research Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
› Author Affiliations
Further Information

Publication History

29 September 2016

21 April 2017

Publication Date:
22 May 2017 (online)

Abstract

Background The concentration and size of lipoprotein particles are associated with race, inflammation, and disease. When triglycerides are high, as in pregnancy, lipoprotein particle size may have physiologic importance beyond conventional lipid measurements. We considered that lipoprotein particles may be related to preterm birth (PTB) and explored race differences.

Materials and Methods Samples were collected at 9 weeks' gestation (22 PTB [< 37 weeks]; 42 term births [≥ 37 weeks]). Lipids were assayed using standard techniques. Concentrations of high-density lipoprotein, low-density lipoprotein, and very low-density lipoprotein particles (HDL-P, LDL-P, and VLDL-P, respectively) and markers of systemic inflammation were quantified using nuclear magnetic resonance spectroscopy and related to PTB.

Results Women with PTB had lower VLDL-P (− 10.66 nmol/L, p = 0.03) and higher systemic inflammation (+ 19.2 µmol/L, p = 0.02) compared with women with term births, independent of race, pre-pregnancy body mass index, and smoking. Black versus white women had lower VLDL-P and higher HDL cholesterol (both p < 0.05). Race-specific results indicated that large HDL-P and inflammation (glycoprotein B) were higher with PTB versus term birth among black women only.

Conclusion Women with PTB had lower VLDL-P early in pregnancy, which may represent impaired lipid response. Black–white differences in the lipoprotein profile are similar to nonpregnant adults, but race-specific lipoprotein and inflammation associations with PTB warrant further study.

* Dr. Scifres' current affiliation is Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma.


 
  • References

  • 1 Institute of Medicine. Preterm Birth: Causes, Consequences, and Prevention. Washington, DC: National Academies Press; 2006
  • 2 Hamilton B, Martin J, Ventura S. Births: preliminary data for 2012. Natl Vital Stat Rep 2013; 62 (03) 1-20
  • 3 Kim SY, Dietz PM, England L, Morrow B, Callaghan WM. Trends in pre-pregnancy obesity in nine states, 1993-2003. Obesity (Silver Spring) 2007; 15 (04) 986-993
  • 4 Catov JM, Bodnar LM, Ness RB, Barron SJ, Roberts JM. Inflammation and dyslipidemia related to risk of spontaneous preterm birth. Am J Epidemiol 2007; 166 (11) 1312-1319
  • 5 Culhane JF, Goldenberg RL. Racial disparities in preterm birth. Semin Perinatol 2011; 35 (04) 234-239
  • 6 Kant AK, Graubard BI. Race-ethnic, family income, and education differentials in nutritional and lipid biomarkers in US children and adolescents: NHANES 2003-2006. Am J Clin Nutr 2012; 96 (03) 601-612
  • 7 Edison RJ, Berg K, Remaley A. , et al. Adverse birth outcome among mothers with low serum cholesterol. Pediatrics 2007; 120 (04) 723-733
  • 8 Catov JM, Ness RB, Wellons MF, Jacobs DR, Roberts JM, Gunderson EP. Prepregnancy lipids related to preterm birth risk: the coronary artery risk development in young adults study. J Clin Endocrinol Metab 2010; 95 (08) 3711-3718
  • 9 Magnussen EB, Vatten LJ, Myklestad K, Salvesen KÅ, Romundstad PR. Cardiovascular risk factors prior to conception and the length of pregnancy: population-based cohort study. Am J Obstet Gynecol 2011; 204 (06) 526.e1-526.e8
  • 10 Alleman BW, Smith AR, Byers HM. , et al. A proposed method to predict preterm birth using clinical data, standard maternal serum screening, and cholesterol. Am J Obstet Gynecol 2013; 208 (06) 472.e1-472.e11
  • 11 Mudd LM, Holzman CB, Catov JM, Senagore PK, Evans RW. Maternal lipids at mid-pregnancy and the risk of preterm delivery. Acta Obstet Gynecol Scand 2012; 91 (06) 726-735
  • 12 Hubel CA, Shakir Y, Gallaher MJ, McLaughlin MK, Roberts JM. Low-density lipoprotein particle size decreases during normal pregnancy in association with triglyceride increases. J Soc Gynecol Investig 1998; 5 (05) 244-250
  • 13 Hubel CA, Lyall F, Weissfeld L, Gandley RE, Roberts JM. Small low-density lipoproteins and vascular cell adhesion molecule-1 are increased in association with hyperlipidemia in preeclampsia. Metabolism 1998; 47 (10) 1281-1288
  • 14 Meyer BJ, Stewart FM, Brown EA. , et al. Maternal obesity is associated with the formation of small dense LDL and hypoadiponectinemia in the third trimester. J Clin Endocrinol Metab 2013; 98 (02) 643-652
  • 15 Mackey RH, Kuller LH, Sutton-Tyrrell K, Evans RW, Holubkov R, Matthews KA. Hormone therapy, lipoprotein subclasses, and coronary calcification: the Healthy Women Study. Arch Intern Med 2005; 165 (05) 510-515
  • 16 Otvos JD, Mora S, Shalaurova I, Greenland P, Mackey RH, Goff Jr DC. Clinical implications of discordance between low-density lipoprotein cholesterol and particle number. J Clin Lipidol 2011; 5 (02) 105-113
  • 17 Jeyarajah EJ, Cromwell WC, Otvos JD. Lipoprotein particle analysis by nuclear magnetic resonance spectroscopy. Clin Lab Med 2006; 26 (04) 847-870
  • 18 Festa A, Williams K, Hanley AJG. , et al. Nuclear magnetic resonance lipoprotein abnormalities in prediabetic subjects in the Insulin Resistance Atherosclerosis Study. Circulation 2005; 111 (25) 3465-3472
  • 19 Garvey WT, Kwon S, Zheng D. , et al. Effects of insulin resistance and type 2 diabetes on lipoprotein subclass particle size and concentration determined by nuclear magnetic resonance. Diabetes 2003; 52 (02) 453-462
  • 20 Sattar N, Greer IA, Galloway PJ. , et al. Lipid and lipoprotein concentrations in pregnancies complicated by intrauterine growth restriction. J Clin Endocrinol Metab 1999; 84 (01) 128-130
  • 21 Thorp Jr JM, Rice MM, Harper M. , et al; Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal–Fetal Medicine Units Network. Advanced lipoprotein measures and recurrent preterm birth. Am J Obstet Gynecol 2013; 209 (04) 342.e1-342.e7
  • 22 Scifres C, Catov J, Simhan H. Maternal race and gestational age dependent changes in maternal serum lipids. Am J Obstet Gynecol 2013; 208: S93-S94
  • 23 Tyroler HA, Glueck CJ, Christensen B, Kwiterovich Jr PO. Plasma high-density lipoprotein cholesterol comparisons in black and white populations. The Lipid Research Clinics Program Prevalence Study. Circulation 1980; 62 (4 Pt 2): IV99-IV107
  • 24 Kwiterovich Jr PO, Virgil DG, Garrett ES. , et al. Lipoprotein heterogeneity at birth: influence of gestational age and race on lipoprotein subclasses and Lp (a) lipoprotein. Ethn Dis 2004; 14 (03) 351-359
  • 25 Sala F, Catapano AL, Norata GD. High density lipoproteins and atherosclerosis: emerging aspects. J Geriatr Cardiol 2012; 9 (04) 401-407
  • 26 Chandra A, Neeland IJ, Das SR. Relation of black race between high density lipoprotein cholesterol content, high density lipoprotein particles and coronary events (from the Dallas Heart Study). Am J Cardiol 2015; 115 (07) 890-894
  • 27 Ugur MG, Kurtul N, Balat O, Ekici M, Kul S. Assessment of maternal serum sialic acid levels in preterm versus term labor: a prospective-controlled clinical study. Arch Gynecol Obstet 2012; 286 (05) 1097-1102
  • 28 Tea I, Le Gall G, Küster A. , et al. 1H-NMR-based metabolic profiling of maternal and umbilical cord blood indicates altered materno-foetal nutrient exchange in preterm infants. PLoS One 2012; 7 (01) e29947 . Doi: 10.1371/journal.pone.0029947
  • 29 Corsetti JP, Gansevoort RT, Sparks CE, Dullaart RP. Inflammation reduces HDL protection against primary cardiac risk. Eur J Clin Invest 2010; 40 (06) 483-489
  • 30 Tehrani DM, Gardin JM, Yanez D. , et al. Impact of Inflammatory Biomarkers on Relation of High Density Lipoprotein-Cholesterol with Incident Coronary Heart Disease: Cardiovascular Health Study. Atherosclerosis 2013; 231 (02) DOI: 10.1016/j.atherosclerosis.2013.08.036.