The impact of maternal obesity and gestational weight gain on early and mid-pregnancy lipid profiles.
Bottom Line: However, cholesterol and LDL increased at a higher weekly rate in normal weight women, resulting in higher total cholesterol in normal weight women (184.1 ± 28.1 vs. 176.0 ± 32.1 mg/dl, P = 0.05) at 24-28 weeks.The rate of change in lipid profiles in either group was not affected by excessive weight gain.Overweight/obese women have significantly more atherogenic lipid profiles than normal weight women during the period of early pregnancy, delineating one physiologic pathway between that could explain differences in pregnancy outcomes normal weight and overweight/obese women.
Affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, Magee Womens Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.Show MeSH
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Mentions: The differences in maternal total cholesterol, LDL, HDL, and triglycerides between normal weight and overweight/obese women in the first and late second trimester suggested that these lipid values have markedly different trajectories between the two groups. Because of this, we sought to examine factors that were associated with the average weekly rate of change for each of these serum lipid values. Univariate analysis of overweight/obese status, smoking, parity, weight gain from pre-pregnancy until the 24–28 week blood draw, and maternal race demonstrated that overweight/obese status was the only variable significantly associated with both the average weekly rate of change in cholesterol (−1.1, 95% CI −1.3 – −0.6, p<0.01) and LDL (−0.6, 95% CI −1.0 – −0.2, p<0.01). Maternal race was associated with the average weekly rate of change in triglycerides (−0.9, 95% CI −1.6 – −.2, p=0.02), but had no significant effect on the relationship between the rate of change in triglycerides and maternal overweight/obese status. Because the relationship between maternal overweight/obese status and the rate of change in lipids were unchanged by any covariates, the results of the unadjusted analysis are shown demonstrating that overweight/obese women had a rate of increase in their total cholesterol and LDL that was significantly lower that the rate of increase in normal weight women (Figure 1). There were no differences in the rate of change in HDL cholesterol or triglycerides between normal weight and overweight/obese women (Figure 1). Furthermore, there was no difference in the weekly rate of change in maternal serum total cholesterol, LDL cholesterol, HDL cholesterol or triglycerides between women with nonexcessive or excessive weight gain in either normal weight or overweight/obese women (Table 3).
Affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, Magee Womens Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.