Maternal plasma cholesterol and duration of pregnancy: A prospective cohort study in Ghana

Low plasma cholesterol may be associated with preterm birth; however, results are mixed and limited primarily to high‐income countries. Our objective was to determine whether maternal plasma lipid concentrations are associated with pregnancy duration. We performed a nested cohort ( n  = 320) study of pregnant Ghanaian women enrolled in a randomized controlled trial. Total cholesterol, high‐density lipoprotein cholesterol (HDL‐C), low‐density lipoprotein cholesterol, and triglyceride concentrations were analyzed in plasma at ≤20and 36 weeks gestation as continuous variables and also categorized into low, referent, or high (<10th, 10th–90th, >90th percentile). At ≤20 weeks, plasma lipid concentrations were not associated with pregnancy duration. At 36 weeks, total cholesterol and triglyceride concentrations were not associated with pregnancy duration. Higher HDL‐C at 36 weeks was associated with a longer pregnancy duration (adjusted β‐coefficient ± standard error: 0.05 ± 0.02 days mg −1 /dL, p  = .02); pregnancy duration was 5.9 ± 2.0 (mean ± standard error) days shorter among women with low HDL‐C compared with the referent group (10th–90th percentile) ( p  = .02) and 8.6 ± 2.6 days shorter when compared with the high HDL‐C group ( p  = .003). Pregnancy duration was 4.9 ± 2.1 days longer among women with low low‐density lipoprotein cholesterol at 36 weeks gestation when compared with the referent group ( p  = .051). Our data suggest that low HDL‐C in the third trimester of pregnancy is associated with a shorter duration of pregnancy in this study population but do not support the hypothesis that low total cholesterol is associated with a shorter pregnancy duration.