Sub-optimal maternal lipid levels during pregnancy may be implicated in the pathophysiological mechanisms leading to low birth weight (LBW) and small-for-gestational-age (SGA). We aimed to determine whether maternal lipid levels across pregnancy were associated with birth weight and the risks of LBW and SGA in rural Gambia. This secondary analysis of the ENID trial involved 573 pregnant women with term deliveries. Plasma levels of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), and triglycerides (TG) were analyzed at enrolment (mean (SD) = 13.9 (3.3) weeks gestation), 20 and 30 weeks gestation as continuous variables and percentile groups. Regression models with adjustment for confounders were used to examine associations between gestational lipid levels and birth weight and the risks of LBW (birth weight < 2500 g) and SGA (<10th percentile INTERGROWTH-21ST for birth weight). There were 7.9% LBW and 32.5% SGA infants. At enrolment, every unit increase in HDL-c was associated with a 2.7% (P = 0.011) reduction in relative risk of LBW. At 20 weeks gestation, every unit increase in TC levels was associated with a 1.3% reduction in relative risk of LBW (P = 0.002). Low (<10th percentile) HDL-c at enrolment or at 20 weeks gestation was associated with a 2.6 (P = 0.007) and 3.0 (P = 0.003) times greater risk of LBW, respectively, compared with referent (10th─90th) HDL-c. High (>90th percentile) LDL-c at 30 weeks gestation was associated with a 55% lower risk of SGA compared with referent LDL-c (P = 0.017). Increased levels of TC (β = 1.3, P = 0.027) at 20 weeks gestation and of TC (β = 1.2, P = 0.006) and LDL-c (β = 1.5, P = 0.002) at 30 weeks gestation were all associated with higher birth weight. In rural Gambia, lipid levels during pregnancy were associated with infant birth weight and the risks of LBW and SGA. Associations varied by lipid class and changed across pregnancy, indicating an adaptive process by which maternal lipids may influence fetal growth and birth outcomes. This trial was registered as ISRCTN49285450 on: 12/11/2009.

中文翻译：

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来自冈比亚农村的一项队列研究：整个妊娠期间孕妇的血脂水平以及小胎龄和低出生体重的风险

孕期孕妇血脂水平欠佳可能与导致低出生体重（LBW）和小胎龄（SGA）的病理生理机制有关。我们的目的是确定冈比亚农村地区孕妇整个妊娠期间的血脂水平是否与出生体重以及LBW和SGA的风险有关。ENID试验的这项二级分析涉及573名足月分娩的孕妇。在入组时分析血浆总胆固醇（TC），高密度脂蛋白胆固醇（HDL-c），低密度脂蛋白胆固醇（LDL-c）和甘油三酸酯（TG）的水平（平均（SD）= 13.9（3.3））妊娠20周和30周）作为连续变量和百分位数组。校正混杂因素的回归模型用于检验妊娠血脂水平与出生体重以及LBW（出生体重<2500 g）和SGA（出生体重<10％INTERGROWTH-21ST）风险之间的关联。有7.9％的LBW婴儿和32.5％的SGA婴儿。入学时，HDL-c的每升高，可使LBW相对风险降低2.7％（P = 0.011）。妊娠20周时，TC水平每升高一个单位，LBW相对风险降低1.3％（P = 0.002）。入选或妊娠20周时低（<10％百分位数）HDL-c分别比参照（第10─90）HDL高2.6倍（P = 0.007）和3.0（P = 0.003） -C。高（> 与参考LDL-c相比，妊娠30周时LDL-c的90％百分率的SGA风险降低了55％（P = 0.017）。妊娠20周时TC（β= 1.3，P = 0.027）的升高水平以及妊娠30周时TC（β= 1.2，P = 0.006）和LDL-c（β= 1.5，P = 0.002）的升高均与妊娠出生体重较高。在冈比亚农村地区，怀孕期间的血脂水平与婴儿出生体重以及LBW和SGA的风险有关。血脂类别之间的联系各不相同，并且在整个怀孕期间都发生变化，这表明母体血脂可能会影响胎儿的生长和出生结局的适应性过程。该试验于2009年12月11日注册为ISRCTN49285450。002）在妊娠30周时，均与较高的出生体重有关。在冈比亚农村地区，怀孕期间的血脂水平与婴儿出生体重以及LBW和SGA的风险有关。血脂类别之间的联系各不相同，并且在整个怀孕期间都发生变化，这表明母体血脂可能会影响胎儿的生长和出生结局的适应性过程。该试验于2009年12月11日注册为ISRCTN49285450。002）在妊娠30周时，均与较高的出生体重有关。在冈比亚农村地区，怀孕期间的血脂水平与婴儿出生体重以及LBW和SGA的风险有关。血脂类别之间的联系各不相同，并且在整个怀孕期间都发生变化，这表明母体血脂可能会影响胎儿的生长和出生结局的适应性过程。该试验于2009年12月11日注册为ISRCTN49285450。