Association of lipid levels at different stages of pregnancy with gestational diabetes mellitus and the incidence of neonatal macrosomia: A retrospective study

• Published in: The journal of obstetrics and gynaecology research Vol. 50; no. 11; pp. 2066 - 2075
• Main Authors: Wang, Xuechun, Wu, Lili, Luo, Haimeng, Zhong, Wenxuan, Zheng, Xiuqiong, Xu, Rongli
• Format: Journal Article
• Language: English
• Published: Kyoto, Japan John Wiley & Sons Australia, Ltd 01-11-2024; Wiley Subscription Services, Inc
• Subjects: Body mass; Cholesterol; Diabetes mellitus; Gestational age; Gestational diabetes; gestational diabetes mellitus; High density lipoprotein; high‐density lipoprotein cholesterol; Lipid metabolism; Lipids; Low density lipoprotein; macrosomia; Neonates; Obstetrics; Pregnancy; Pregnancy complications; Risk factors; Serum levels; triglyceride to high‐density lipoprotein cholesterol ratio; Triglycerides; gestational diabetes mellitus; triglycerides; macrosomia; triglyceride to high‐density lipoprotein cholesterol ratio; high‐density lipoprotein cholesterol
• ISSN: 1341-8076; 1447-0756; 1447-0756
• DOI: 10.1111/jog.16109

Objective
To investigate the correlation between lipid levels during gestation and the incidence rate of gestational diabetes mellitus (GDM) and macrosomia.
Method
Clinical records of 607 pregnant women with GDM (GDM group) who delivered in the Obstetrics Department of Fujian Maternal and Child Health Hospital from May to December 2018 and of 833 women with uncomplicated pregnancies (control group) were retrospectively analyzed. After delivery, the entire cohort was further grouped based on the weight of the neonates: women who delivered newborns with body mass <4 kg comprised the normal group (n = 1367), and pregnancies that resulted in delivery of neonates with body mass >4 kg were classified as the macrosomia group (n = 73). Fasting serum levels of triglycerides (TG), total cholesterol (TC), high‐density lipoprotein cholesterol (HDL‐C), low‐density lipoprotein cholesterol (LDL‐C), and TG/HDL‐C ratio were compared between the groups at the early (10–12 weeks), middle (24–28 weeks), and late (28 weeks‐delivery) stages of pregnancy, and the correlation between the lipid indices and the rates of GDM and macrosomia were analyzed.
Results
There was a gradual increase in TC, TG, LDL‐C, and TG/HDL‐C levels with increasing gestational weeks in pregnant women. TG and TG/HDL‐C levels were markedly higher, while HDL‐C was lower in women with GDM compared with women of the same gestational age with uncomplicated pregnancies (p < 0.05).
Conclusion
Lipid metabolism disorders exist in pregnant women with GDM at different gestational stages and are closely related to the higher incidence of macrosomia. TG, TG/HDL‐C, and HDL‐C in early and late pregnancy are independent risk factors for macrosomia in all trimesters, and TG/HDL‐C ratio at different gestational stages has a good predictive value for macrosomia.