The Associations of Maternal Blood Hemoglobin and Serum Triglyceride Levels and the Risk of Preterm Delivery

Abstract

The abnormal hemoglobin (HGB) and serum lipid concentrations during pregnancy will increase the risk of preterm delivery. Our study aimed to explore the correlation between prenatal HGB and serum lipid levels and preterm delivery. We enrolled 215 mother-infant pairs in a pilot cohort study. The logistic regression model and Restricted Cubic Spline model (RCS) were used to investigate the levels of prenatal blood HGB and serum lipid such as triglyceride (TG), total cholesterol, high-density lipoprotein, low density lipoprotein and preterm delivery. The results showed that moderate levels of prenatal blood HGB (OR=0.28; 95%CI: 0.10, 0.75, p-trend=0.018) and high level of serum TG (OR=0.29; 95%CI: 0.10, 0.84, p-trend=0.022) level were negatively associated with the risk of preterm delivery. The joint effect results showed that compared with lower level of prenatal blood HGB (≤123.13 g/l) and TG (≤3.7 mmol/l), we found that high levels prenatal blood HGB and serum TG (OR=0.32, 95%CI: 0.12, 0.89) had a negative association with the risk of preterm delivery. Moreover, prenatal blood HGB and serum TG levels had negative linear dose-effect relationships with the risk of preterm delivery in overall and girl group (p<0.05). Moderate levels of prenatal blood HGB and high level of serum TG were negatively associated with the risk of preterm delivery. The joint effect of high levels prenatal HGB and prenatal serum TG in the normal range were negatively correlated with preterm delivery. Moreover, the underlying mechanisms should be clarified in future studies.

Key words

hemoglobin - triglyceride - preterm delivery - joint effect

Publikationsverlauf

Eingereicht: 06. April 2023

Angenommen nach Revision: 26. September 2023

Artikel online veröffentlicht:
30. Oktober 2023

• References

• 1 Liu L, Johnson HL, Cousens S. et al. Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet 2012; 379: 2151-2161
• 2 Blencowe H, Cousens S, Oestergaard MZ. et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. Lancet 2012; 379: 2162-2172
• 3 Zhu Z, Yuan L, Wang J. et al Mortality and morbidity of infants born extremely preterm at tertiary medical centers in China from 2010 to 2019. JAMA. 2021; network open 4: e219382
• 4 Scholl TO, Hediger ML, Fischer RL. et al. Anemia vs iron deficiency: increased risk of preterm delivery in a prospective study. Am J Clin Nutr 1192 55: 985-988
• 5 Young MF, Oaks BM, Tandon S. et al. Maternal hemoglobin concentrations across pregnancy and maternal and child health: a systematic review and meta-analysis. Ann N Y Acad Sci 2019; 1450: 47-68
• 6 Rahman MM, Abe SK, Rahman MS. et al. Maternal anemia and risk of adverse birth and health outcomes in low- and middle-income countries: systematic review and meta-analysis. Am J Clin Nutr 2016; 103: 495-504
• 7 Smedts HP, van Uitert EM, Valkenburg O. et al. A derangement of the maternal lipid profile is associated with an elevated risk of congenital heart disease in the offspring. Nutr Metab Cardiovasc Dis 2012; 22: 477-485
• 8 Waage CW, Mdala I, Stigum H. et al. Lipid and lipoprotein concentrations during pregnancy and associations with ethnicity. BMC Pregnancy Childbirth 2022; 22: 246
• 9 Herrera E, Lasunción MA, Gomez-Coronado D. et al. Role of lipoprotein lipase activity on lipoprotein metabolism and the fate of circulating triglycerides in pregnancy. Am J Obstet Gynecol 1988; 158: 1575-1583
• 10 Cantin C, Fuenzalida B, Leiva A. Maternal hypercholesterolemia during pregnancy: Potential modulation of cholesterol transport through the human placenta and lipoprotein profile in maternal and neonatal circulation. Placenta 2020; 94: 26-33
• 11 Yalçin SS, Dut R, Yurdakök K. et al. Seasonal and gender differences in hemoglobin value in infants at 5-7 months of age. Turk J Pediatr 2009; 51: 572-577
• 12 Hou Q, Huang L, Ge X. et al. Associations between multiple serum metal exposures and low birth weight infants in Chinese pregnant women: A nested case-control study. Chemosphere 2019; 231: 225-232
• 13 Ren A, Wang J, Ye RW. et al. Low first-trimester hemoglobin and low birth weight, preterm birth and small for gestational age newborns. Int J Gynaecol Obstet 2007; 98: 124-128
• 14 Zhang Q, Ananth CV, Li Z. et al. Maternal anaemia and preterm birth: a prospective cohort study. Int J Epidemiol 2009; 38: 1380-1389
• 15 Kumari S, Garg N, Kumar A. et al. Maternal and severe anaemia in delivering women is associated with risk of preterm and low birth weight: A cross sectional study from Jharkhand, India. One Health 2019; 8: 100098
• 16 Gonzales GF, Steenland K, Tapia V. Maternal hemoglobin level and fetal outcome at low and high altitudes. Am J Physiol Regul Integr Comp Physiol 2009; 297: R1477-R1485
• 17 Dewey KG, Oaks BM. U-shaped curve for risk associated with maternal hemoglobin, iron status, or iron supplementation. Am J Clin Nutr 2017; 106: 1694s-1702s
• 18 Yi SW, Han YJ, Ohrr H. Anemia before pregnancy and risk of preterm birth, low birth weight and small-for-gestational-age birth in Korean women. Eur J Clin Nutr 2013; 67: 337-342
• 19 Bánhidy F, Ács N, Puhó EH. et al. Iron deficiency anemia: pregnancy outcomes with or without iron supplementation. Nutrition 2011; 27: 65-72
• 20 Larsen S, Bjelland EK, Haavaldsen C. et al. Placental weight in pregnancies with high or low hemoglobin concentrations. Eur J Obstet Gynecol Reprod Biol 2016; 206: 48-52
• 21 Wang C, Lin L, Su R. et al. Hemoglobin levels during the first trimester of pregnancy are associated with the risk of gestational diabetes mellitus, pre-eclampsia and preterm birth in Chinese women: a retrospective study. BMC Pregnancy Childbirth 2018; 18: 263
• 22 Bobiński R, Mikulska M. The ins and outs of maternal-fetal fatty acid metabolism. Acta Biochim Pol 2015; 62: 499-507
• 23 Pecks U, Mohaupt MG, Hütten MC. et al. Cholesterol acceptor capacity is preserved by different mechanisms in preterm and term fetuses. Biochim Biophys Acta 2014; 1841: 251-258
• 24 Moayeri M, Heida KY, Franx A. et al. Maternal lipid profile and the relation with spontaneous preterm delivery: a systematic review. Arch Gynecol Obstet 2017; 295: 313-323
• 25 Chen X, Scholl TO. Association of elevated free fatty acids during late pregnancy with preterm delivery. Obstet Gynecol 2008; 112: 297-303
• 26 Perrone S, Tataranno ML, Negro S. et al. Placental histological examination and the relationship with oxidative stress in preterm infants. Placenta 2016; 46: 72-78
• 27 Jiang S, Jiang J, Xu H, Wang S, Liu Z. et al. Maternal dyslipidemia during pregnancy may increase the risk of preterm birth: a meta-analysis. Taiwan J Obstet Gynecol 2017; 56: 9-15