Relationship between changes of high-density lipoprotein cholesterol levels in advanced pregnancy and the risk of neonatal small for gestational age in healthy full-term puerpera.

OBJECTIVE

To explore the relationship between changes in blood high-density lipoprotein cholesterol (HDL-C) levels in advanced pregnancy and the risk of small for gestational age (SGA) in healthy full-term pregnant women.

METHODS

In this retrospective nested case-control study, pregnant women who got antenatal visits and experienced a healthy full-term delivery in Affiliated Women's Hospital, Zhejiang University School of Medicine in 2017 were enrolled. From the cohort, 249 women delivered SGA infants with completed clinical data were set as SGA group, 996 women who delivered normal neonates were randomly selected as matched controls (1∶4). The data of baseline characteristics, the HDL-C levels in 24 -27 week and after 37 week were collected, the average HDL-C changes every four weeks in the third trimester (ΔHDL-C) were calculated. Paired test was used to compare the differences of HDL-C and ΔHDL-C between cases and controls, and a conditional logistic regression model was applied to analyze the association between ΔHDL-C and the risk of SGA.

RESULTS

HDL-C levels after the 37 week in both groups were lower than those in mid-pregnancy (ΔHDL-C<0 and <0.05 for both groups), while the ΔHDL-C levels in SGA group were significantly higher ( <0.05). Compared with women with low ΔHDL-C, the risk of SGA was higher for women with middle and high ΔHDL-C ( =1.74, 95% ：1.22-2.50; =2.48, 95% ：1.65-3.70, both <0.05).

CONCLUSION

In healthy full-term pregnant women, the risk of SGA is associated with the HDL-C changing trend, HDL-C level decreasing slowly or even raising in the third trimester indicate that SGA may be likely to occur.