Scholarlink

Objective <p>Maternal dyslipidemia during pregnancy affects occurrence of preterm birth (PTB), either spontaneous or iatrogenic, with varied mechanisms. This study aims at the trajectories of and trimester-specific six maternal lipids indices in relation to PTB and its subtypes.</p> Methods <p>A cohort study was established on pregnant women who were screened for Down syndrome and followed up till termination of pregnancy. Lipid data were extracted from electronic medical records including triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C), and then linked with the cohort above. Non-HDL-C and atherogenic index of plasma (AIP) were calculated. Lipid dynamics across gestation were characterized by a generalized additive mixed model. Associations, overall and dose-response, of lipids with PTB and its subtypes were estimated respectively by a multivariable logistic regression model and a restricted cubic spline analysis.</p> Results <p>Among the 2,749 pregnant women included in the final analysis, 137 (5.0%) delivered preterm. The six lipid indices differed in patterns across gestation. PTB-specific trajectories were clearly distinguishable from those of term birth for AIP throughout pregnancy and TG after about 20 weeks of gestation. Further, mid-pregnancy increments in AIP were strongly associated with higher odds of PTB (adjusted odds ratio [aOR] = 1.36, 95% confidence interval [CI]: 1.06–1.74 per standard deviation [SD]) and its iatrogenic subtype (aOR = 1.58, 95% CI: 1.05–2.38 per SD), and in a linear dose response. The aORs ranged from 1.29 to 1.50 for PTB with mid-pregnancy TG or non-HDL-C, iatrogenic PTB with mid-pregnancy TG or late-pregnancy TC, spontaneous PTB with mid-pregnancy non-HDL-C, and preterm premature rupture of the membranes with TG in mid-pregnancy, all per SD increment of the lipids above.</p> Conclusions <p>Maternal lipids display distinct trajectories across gestation and affect occurrence of PTB. Disturbance of the TG-HDL-C axis such as high AIP, TG and non-HDL-C in mid- and late- pregnancy plays an important role on PTB, especially for its iatrogenic subtype.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Trajectories of and trimester-specific six maternal lipid indices during pregnancy associated with preterm birth and its subtypes: a cohort-based record-linkage study

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年5月11日

查看全文
  • Meng-ting Cao,
  • Qing Li,
  • Bai-xue Han,
  • Zong-guang Li,
  • Yao Dong,
  • Hai-yan Liu,
  • Jin-jin Liu,
  • Zi-qiang Qian,
  • Long-nan Pan,
  • An-qun Hu,
  • Yong-fu Yu,
  • Ying-jie Zheng

摘要

Objective

Maternal dyslipidemia during pregnancy affects occurrence of preterm birth (PTB), either spontaneous or iatrogenic, with varied mechanisms. This study aims at the trajectories of and trimester-specific six maternal lipids indices in relation to PTB and its subtypes.

Methods

A cohort study was established on pregnant women who were screened for Down syndrome and followed up till termination of pregnancy. Lipid data were extracted from electronic medical records including triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C), and then linked with the cohort above. Non-HDL-C and atherogenic index of plasma (AIP) were calculated. Lipid dynamics across gestation were characterized by a generalized additive mixed model. Associations, overall and dose-response, of lipids with PTB and its subtypes were estimated respectively by a multivariable logistic regression model and a restricted cubic spline analysis.

Results

Among the 2,749 pregnant women included in the final analysis, 137 (5.0%) delivered preterm. The six lipid indices differed in patterns across gestation. PTB-specific trajectories were clearly distinguishable from those of term birth for AIP throughout pregnancy and TG after about 20 weeks of gestation. Further, mid-pregnancy increments in AIP were strongly associated with higher odds of PTB (adjusted odds ratio [aOR] = 1.36, 95% confidence interval [CI]: 1.06–1.74 per standard deviation [SD]) and its iatrogenic subtype (aOR = 1.58, 95% CI: 1.05–2.38 per SD), and in a linear dose response. The aORs ranged from 1.29 to 1.50 for PTB with mid-pregnancy TG or non-HDL-C, iatrogenic PTB with mid-pregnancy TG or late-pregnancy TC, spontaneous PTB with mid-pregnancy non-HDL-C, and preterm premature rupture of the membranes with TG in mid-pregnancy, all per SD increment of the lipids above.

Conclusions

Maternal lipids display distinct trajectories across gestation and affect occurrence of PTB. Disturbance of the TG-HDL-C axis such as high AIP, TG and non-HDL-C in mid- and late- pregnancy plays an important role on PTB, especially for its iatrogenic subtype.