Are maternal metabolic syndrome and lipid profile associated with preterm delivery and preterm premature rupture of membranes?

Aim: We aimed to evaluate the association of metabolic syndrome (MetS), its components and lipid profile in mid-pregnancy with preterm delivery and preterm premature rupture of membranes (PPROM).

Methods: This prospective cohort study was conducted on 203 pregnant women between 24 and 28 weeks of gestation, undergoing gestational diabetes screening test with 50 g glucose challenge test (GCT). Fasting serum total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG) levels were measured during the week after GCT assessment. Information on the participants' pre-pregnancy weight, demographic/reproductive characteristics, and height and blood pressure (BP) measurements were documented at baseline entry into the study. Metabolic syndrome was defined as the co-existence of 3 or more of the following criteria: Body mass index (BMI) before pregnancy ≥ 30 kg/m², BP ≥ 130/85 mmHg, GCT ≥ 140 mg/dl, TG ≥ 150 mg/dl, and HDL-C ≤ 50 mg/dl. All participants were followed through routine prenatal care, up to delivery. Any deliveries or rupture of membranes of less than 37 weeks of pregnancy were considered preterm delivery and PPROM, respectively. Statistical analysis was performed by SPSS V.20, and p value of less than 0.05 was considered significant.

Findings: MetS was detected in 10 (4.9%) of participants. Logistic regression analysis showed HDL-C levels, and hypertension were associated with spontaneous preterm delivery [(OR 0.952, 95% CI 0.910-0.995), (OR 1.629, 95% CI 1.554-1.709) respectively], but no statistically significant results were found for PPROM.

Conclusions: Low HDL-C levels and hypertension in mid-pregnancy are associated with the occurrence of spontaneous preterm deliveries, indicating that MetS and its components should be monitored more closely in pregnancy.

Keywords: Lipid profile; Metabolic syndrome; Pregnancy; Preterm delivery; Preterm premature rupture of membranes.