İlk Trimester Serum Lipid Profili ile Postterm Gebelik İlişkisi

Abstract

Amaç: Çalışmada ilk trimesterdeki lipid profili ile postterm gebelik (PTG) arasındaki ilişkiyi ve lipid profilinin PTG için bir öngörü kriteri olup olamayacağını değerlendirmeyi amaçladık.

Materyal ve Metot: Çalışmaya postterm dönemdeki 329 (vaka grubu) ve term dönemdeki 97 (kontrol grubu) gebe dahil edildi. Hastaların demografik bilgileri, doğum şekilleri, ilk trimester lipid profilleri (total kolesterol, trigliserid, HDL-K, LDL-K, VLDL-K düzeyleri) ile doğan bebeklerin APGAR skoru ve yenidoğan yoğun bakım (YDYB) kabulu kaydedildi. Çalışmada gruplar arasındaki lipid profil farklılıkları değerlendirildi.

Bulgular: Gruplar arasında yaş, gebelik sayısı, parite ve vücut kitle indeksi (VKI) açısından anlamlı farklılık saptanmazken, ortalama APGAR skorları (p<0,001) ve YDYB ihtiyacı (p<0,001) açısından anlamlı farklılık tespit edildi. PTG grubunda sezaryen (C/S) olma oranı term gruba göre daha yüksekti ve fark istatistiksel olarak anlamlı bulundu (p<0,001). Gruplar arasında lipid profilleri değerlendirildiğinde; total kolesterol, trigliserid, HDL-K, LDL-K ve VLDL-K düzeylerinin PTG grubunda anlamlı olarak daha düşük olduğu saptandı (p<0,05).

Sonuç: Çalışmada, ilk trimester lipid düzeyi düşüklüğü ile PTG arasında anlamlı bir ilişki tespit edildi. Gebede ilk trimesterdeki düşük lipid seviyeleri, PTG’i öngörmek için bir kriter olarak değerlendirilebilir. Bununla beraber PTG’ye neden olabilecek başka faktörlerde bulunduğundan lipid profili ile PTG arasındaki ilişkinin daha iyi anlaşılabilmesi için destekleyici prospektif çalışmalara ihtiyaç vardır. 

Keywords

• İlk trimester
• kolesterol
• lipid profili
• Postterm gebelik
• trigliserid

Relationship between Postterm Pregnancy and First Trimester Serum Lipid Profile

Abstract

Objective: In this study, we investigated the association between first trimester lipid profile and postterm pregnancy (PTG) and whether lipid profile can be a predictive criterion for the development of PTG.

Materials and Methods: 329 pregnant women with postterm delivery and 97 pregnant women with term delivery were included in the study. Demographic data, mode of delivery, first trimester lipid profiles (total cholesterol, triglyceride, HDL-C, LDL-C, VLDL-C), APGAR score of the babies born, and whether they required neonatal intensive care. In the study, the lipid profile differences between the groups were evaluated.

Results: While no significant difference was found between the postterm and term pregnancy groups in terms of age, number of pregnancies, parity, and body mass index (BMI), a statistically significant difference was found in terms of mean APGAR score (p < 0.001) and YDYB requirement (p < 0.001). The rate of cesarean section in PTG group was higher than in term pregnancies and the difference was statistically significant (p < 0.001). When the lipid profiles were evaluated between the groups, it was found that the levels of total cholesterol, triglyceride, HDL-C, LDL-C and VLDL-C levels were significantly lower in the PTG group (p < 0.05).

Conclusion: In our study, low lipid levels in the first trimester were found to be associated with PTG. Low lipid levels in the first trimester of pregnancy can be considered as a criterion for predicting PTG. However, because there are other factors that may cause PTG, supportive prospective studies are needed to better understand the relationship between lipid profile and PTG.   

Keywords

• First trimester
• cholesterol
• lipid profile
• postterm pregnancy
• triglyceride

References

1. Lee CP, Lam H, Leung WC, Lao TT. The use of fetal Doppler cerebroplacental blood flow and amniotic fluid volume measurement in the surveillance of postdated pregnancies. Acta Obstet Gynecol Scand. 2016;84(9):844-848.
2. American College of Obstetricians and Gynecologists (ACOG). Management of late-term and postterm pregnancies: ACOG Practice Bulletin Number 146. Obstet Gynecol. 2014;124:390-396.
3. Defrin D, Yerizel E, Suhaimi D, Afriwardi A. The Reactivity Levels of Progesterone, Nitric Oxide and Nuclear Factor Kappa-B on the Serum of Term and Post-Term Pregnancy, Clinical Study in Padang, West Sumatera, Indonesia. Maced J Med Sci. 2019;7(11):1729-1732.
4. Bayraktar B, Vural T, Gölbaşı C, Gölbaşı H, Bayraktar MG. Fetal gender distribution in post-term pregnancy and intrauterine death: Maternal and neonatal outcomes by fetal sex. Gülhane Med J. 2022;64(1):73-78.
5. Latif S, Aiken C. Prolonged pregnancy. Obstet Gynaecol Reprod Med. 2021;31(6):170-174.
6. Waage CW, Mdala I, Stigum H, ve ark. Lipid and lipoprotein concentrations during pregnancy and associations with ethnicity. BMC Pregnancy Childbirth. 2022;22(1):246. doi:10.1186/s12884-022-04524-2
7. Pusukuru R, Shenoi AS, Kyada PK, ve ark. Evaluation of Lipid Profile in Second and Third Trimester of Pregnancy. J Clin Diagn Res, 2016;10(3):12-16.
8. Vitoratos N, Papatheodorou DC, Kalantaridou SN, Mastorakos G. "Reproductive" corticotropin-releasing hormone. Ann N Y Acad Sci. 2006;1092:310-318.

9. Yang R, You X, Tang X, Gao L, Ni X. Corticotropin-releasing hormone inhibits progesterone production in cultured human placental trophoblasts. J Mol Endocrinol. 2006;37(3):533-540.
10. Vrijkotte TG, Krukziener N, Hutten BA, ve ark. Maternal lipid profile during early pregnancy and pregnancy complications and outcomes: the ABCD study. J Clin Endocrinol Metab. 2012;97(11):3917–3925.
11. Catov JM, Bodnar LM, Kip KE, ve ark. Early pregnancy lipid concentrations and spontaneous preterm birth. Am J Obstet Gynecol. 2007;197:610-617.
12. Grantz KL, Elmi A, Pugh SJ, Catov J, Sjaarda L, Albert PS. Maternal Serum Lipid Trajectories and Association with Pregnancy Loss and Length of Gestation. Am J Perinatol. 2020;37(9):914-923.
13. Laughon SK, McLain AC, Sundaram R, Catov JM, Buck Louis GM. Maternal lipid change in relation to length of gestation: a prospective cohort study with preconception enrollment of women. Gynecol Obstet Invest 2014;77(1):6-13.
14. Edison RJ, Berg K, Remaley A, ve ark. Adverse birth outcome among mothers with low serum cholesterol. Pediatrics. 2007;120:723-733.
15. Xie D, Yang W, Wang A, ve ark. Effects of pre-pregnancy body mass index on pregnancy and perinatal outcomes in women based on a retrospective cohort. Sci Rep. 2021;11(1):19863. doi:10.1038/s41598-021-98892-y
16. Almeida NK, Almeida RM, Pedreira CE. Adverse perinatal outcomes for advanced maternal age: a cross-sectional study of Brazilian births. J Pediatr (Rio J). 2015;91(5):493–498.
17. Kortekaas JC, Kazemier BM, Keulen JKJ, ve ark. Risk of adverse pregnancy outcomes of late- and postterm pregnancies in advanced maternal age: A national cohort study. Acta Obstet Gynecol Scand. 2020;99(8):1022-1030.
18. Mehari MA, Maeruf H, Robles CC, ve ark. Advanced maternal age pregnancy and its adverse obstetrical and perinatal outcomes in Ayder comprehensive specialized hospital, Northern Ethiopia, 2017: a comparative cross-sectional study. BMC Pregnancy Childbirth. 2020;20(1):60. doi:10.1186/s12884-020-2740-6
19. Deepti GI, Shetty S, Rao AV, Ahmed S. Age related difference in the lipid profile in normal healthy women. Nitte University Journal of Health Science. 2014;4(2):94-97.
20. Rydahl E, Eriksen L, Juhl M. Effects of induction of labor prior to post-term in low-risk pregnancies: a systematic review. JBI Database System Rev Implement Rep. 2019;17(2):170-208.
21. Pradeep P, Arunkumar T, Sundari S. Comparative study of cord blood lipid profile in preterm and post term neonates. Int J Contemp Pediatr. 2019;6(6):2273-2276.
22. Kermani A, Namakin K, Sharifzadeh G R, Faal G R. Umbilical Cord Blood Lipid Profile in Healthy Neonates in Iran. Iran J Pediatr. 2020;30(3):e99114. doi:10.5812/ijp.99114
23. Gupta R, Goyal A, Gupta M. Study of cord blood lipid profile at birth and its relation to gestational maturity and birth weight. Asian Journal of Medical Sciences. 2021;12(1):20-23.
24. Kenchappa Y, Behera N. Assay of neonatal cord blood lipid levels and its correlation with neonatal gestational age, gender and birth weight: a single center experience. Int J Contemp Pediatr. 2016;3(3):718-724.
25. Ramy N, Zakaria M, El Kafoury M, Kamal M. Cord blood lipid profile in relation to anthropometric measures of newborns. Kasr Al Ainy Medical Journal. 2017;23(1):54-58.