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Low Plasma Concentrations of High‐Density Lipoprotein Cholesterol (HDL‐C) Associated with Shorter Duration of Pregnancy: A Nested Cohort Study in Ghana
Author(s) -
Oaks Brietta M,
Stewart Christine P,
Laugero Kevin D,
AduAfarwuah Seth,
Lartey Anna,
Vosti Stephen A,
Ashorn Per,
Dewey Kathryn G
Publication year - 2016
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.30.1_supplement.33.8
Subject(s) - gestation , medicine , gestational age , pregnancy , nested case control study , cholesterol , endocrinology , high density lipoprotein , cohort , obstetrics , biology , genetics
Background Recent studies have suggested that low serum cholesterol is associated with preterm birth (birth < 37 wk gestation), however results are mixed and research has been limited primarily to populations from high‐income countries. Objective To determine whether maternal blood lipid concentrations, at ≤ 20 wk or 36 wk gestation, are associated with duration of gestation. Methods We performed a nested cohort (n=320) study of pregnant Ghanaian women ≤ 20 wk gestation enrolled in a large randomized controlled trial. Total cholesterol, high density lipoprotein cholesterol (HDL‐C), low density lipoprotein cholesterol (LDL‐C), and triglycerides were analyzed in plasma samples, and gestational age was determined by ultrasound at baseline. A linear regression model examined the association between each blood lipid and duration of gestation. Blood lipids were examined both as continuous variables and categorically as low (<10 th percentile), referent (10–90 th percentile), and high (>90 th percentile). Results At baseline, blood lipid concentrations were not associated with duration of gestation. At 36 wk gestation, higher HDL‐C was associated with a longer duration of gestation (β‐coefficient ± SE: 1.8 ± 0.7 days/mmol/L, p=0.02), independent of assigned group in trial, gestational age at enrollment, maternal baseline BMI, woman's age, parity, infant gender, asset index, season at enrollment, and time between sample collection and last meal. Among women with low HDL‐C at 36 wk gestation, duration of gestation was 5.9 days shorter when compared with the referent group (10–90 th percentile) (p = 0.02) and 8.5 days shorter when compared with the high HDL‐C group (p = 0.003). LDL‐C was not significantly associated with duration of gestation at 36 wk gestation in linear regression analyses (adjusted β‐coefficient ± SE: −1.2 ± 0.7 days/mmol/L, p=0.08). Among women with low LDL‐C at 36 wk gestation, duration of gestation was 4.9 days longer when compared with the referent group (p = 0.051). Total cholesterol and triglycerides were not significantly associated with pregnancy duration. Conclusion Low HDL‐C in the third trimester of pregnancy is associated with a shorter duration of pregnancy in this study population of Ghanaian women. Support or Funding Information Bill & Melinda Gates Foundation.