Maternal Lipid Profile Tied to Pediatric CHD Risk

Congenital heart disease (CHD among live births, is the major form of birth defect and the leading cause of childhood mortality with an incidence of 9.1‰. The occurrence of CHD is caused by many factors.

With the improvement in living standards and an increasing number of women with advanced maternal age, there is an increase in the prevalence of chronic metabolic diseases, such as obesity, diabetes, hypertension, and hyperlipidemia, among pregnant women.

Clinical Scientists at the Children's Hospital of Fudan University (Shanghai, China) carried out a single-center case–control study that included 230 mothers of offspring with CHD and 381 without CHD. Maternal lipid levels were determined on fasting blood samples taken in the first trimester. Relevant demographic and clinical data were extracted from the medical records. Maternal lipid profile was compared between the two groups, and regression analysis was performed to evaluate the association between lipid profile and CHD risk in offspring.

Fasting peripheral blood samples were collected between eight and 14 weeks of gestation. Folic acid, vitamin B12, thyroid abnormality, homocysteine (Hcy), triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), free fatty acid, Apolipoprotein-A1 (Apo-A1), Apolipoprotein-B (Apo-B), fasting blood glucose, and hemoglobin A1c (HbA1c) were all measured. TG, TC, HDL-C, LDL-C, free fatty acid, Apo-A1, Apo-B, and fasting blood glucose were analyzed by an automatic biochemical analyzer (Hitachi 7180, Tokyo, Japan) using commercially available kits. Folic acid and vitamin B12 were measured using the Architect i2000chemiluminescence immunoassay analyzer (Abbott, Lake Forest, IL, USA). Serum Hcy measurements were carried out by Liquid Chromatography Coupled to Tandem Mass Spectrometry (LC/MS/MS) using an API 3000 LC/MS/MS system (Applied Biosystems, Waltham, MA, USA).

The investigators reported that compared with the control group, levels of triglyceride, apolipoprotein-A1, and apolipoprotein-B in early pregnancy were significantly higher in the CHD group. Multivariate analyses showed that triglyceride (odds ratio [OR] 2.46), total/high-density lipoprotein cholesterol (OR 2.10), and apolipoprotein-A1 (OR 2.73), were positively associated with CHD risk in offspring. Each lipid biomarker was associated with an almost twofold increased risk of CHD, independent of HbA1c and Hcy.

The authors concluded that mild dyslipidemia in early pregnancy was closely associated with the occurrence of CHD in offspring. In combination with previous studies, it is possible that lipid metabolism in early pregnancy may influence the outcome of pregnancy. The study was published on August 3,2021 in the journal Acta Obstetricia et Gynecologica Scandinavica.

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Children's Hospital of Fudan University
Hitachi 
Abbott
Applied Biosystems