Maternal and Cord Blood Lipids in Pregnant Women With Obesity and Their Impact on Neonatal and Placental Biometric Features.

Abstract

Objective: Maternal obesity and excessive weight gain during pregnancy predispose to adverse fetal outcomes and health issues for the offspring. Although maternal lipids play an important role in excess fetal fat accretion, previous studies found heterogeneous results regarding which lipid fraction is most involved in excessive fetal growth in maternal obesity and the role of cord lipids. The aim of this study was to evaluate lipid concentrations in maternal and cord blood in pregnant women with and without obesity and to correlate lipid profile with neonatal and placental biometric parameters.

Methods: This is a prospective case-control study comparing 58 pregnant women with and without obesity enrolled from January 2021 to January 2022 at IRCCS Policlinico San Matteo. Lipid profiles at trimesters and in cord blood were tested. Statistical analysis was conducted with a nonparametric rank-based approach for longitudinal data analysis.

Results: In both overall and time point analyses, maternal lipid concentrations were higher in participants with obesity than in subjects without obesity. Women with obesity also had higher total cholesterol and triglyceride cord blood concentrations (p < 0.001). Among participants with obesity, neonatal and placental weights were positively correlated with triglycerides and the triglycerides/HDL ratio both in maternal and in cord blood. Finally, among subjects with obesity, maternal and cord blood triglycerides and triglycerides/HDL ratio were significantly higher in large for gestational age (LGA) babies compared to non-LGA (p < 0.05).

Conclusions: Compared with controls, obesity in pregnancy is associated with a significant increase in maternal and cord blood lipids, with a positive association between maternal and cord triglycerides and birthweight and placental weight. These findings suggest a further insight into maternal obesity pathophysiology leading to excessive fetal growth, dyslipidemia and insulin resistance in the offspring.