Association of hyperlipidemia in preterm delivery


  • S. Sowmiya Department of Obstetrics & Gynecology, SVMCH & RC, Ariyur, Pondicherry, India
  • P. B. Hiremath Department of Obstetrics & Gynecology, SVMCH & RC, Ariyur, Pondicherry, India
  • Mercy Kousalya Department of Obstetrics & Gynecology, SVMCH & RC, Ariyur, Pondicherry, India



Preterm, Labor, Cholesterol, Hyperlipidemia, Predictor, Marker


Background: There are 3.6 million/year neonatal deaths around the world, of which 99 percent deaths are contributed by the developing countries. An infant born before 37 completed weeks is called as preterm. Normal human pregnancy results in a pronounced physiological hypertriglyceridemia involving a gestational rise in blood triglycerides (TGL) and cholesterol.  As elevated circulating levels of triglycerides and cholesterol are markers for increased risk of preterm labor in pregnant women. Atherosis of the Utero placental spiral arteries may be induced by the Hyperlipidemia in pregnancy to cause preterm delivery.

Methods: The study group included 444 healthy pregnant women in the age group of 17-35 years and whose gestational age was confirmed either by their last menstrual period or by dating ultrasound. This study was conducted to evaluate the association of elevated serum triglycerides and cholesterol levels, in an uncomplicated pregnancy and preterm delivery. In all these antenatal mothers (study group) a detailed history with special reference to diet and habits, followed by a complete obstetric and general examination were done. All antenatal mothers who were included in the study were subjected for serum triglycerides and cholesterol estimation from the overnight fasting blood samples, at 24, 28, & 32 weeks of gestation.

Results: In this study 374 patients who had normal cholesterol delivered at term, however 15 patients out of 26 (42.5%) patients who showed abnormal cholesterol had preterm delivery and 22 patients out of 35 (62.8%) patients with abnormal triglycerides level delivered prematurely.

Conclusions: The measurement of serum total cholesterol and triglycerides along with other measures like clinical and serum screening of Alpha fetoprotein and inhibin A can potentially be used for predicting the preterm labor


Cunningham G, Leveno KJ, Bloom SL, Hauth JC, Gilstrap LC, Wenstrom KD. Preterm birth. In: Gary Cunningham, Kenneth J. Leveno, Steven L. Bloom, John C. Hauth, Larry C. Gilstrap III, Katharine D. Wenstrom, eds. Williams Obstetrics. 22nd ed. New Delhi: McGraw-Hill Medical Publishing Division; 2005: 855-880.

Dutta DC. Physiological changes during pregnancy. In: Hiralal Konar, eds. Text Book of Obstetrics. 7th ed. New Delhi: Jaypee Medical Publishers; 2013:46-56.

Rafael TJ, Hoffman MK, Leiby BE, Berghella V. Gestational age of previous twin preterm birth as a predictor for subsequent singleton preterm birth. Am J Obstet Gynecol. 2012;156.e1-6.

Institute of Medicine (US) Committee on Understanding Premature Birth and Assuring Healthy Outcomes. Preterm birth: causes, consequences, and prevention. In: Behrman RE, Butler AS, eds. A Book. Washington: National Academies Press; 2007.

Lawn JE, Kerber K, Enweronu-Laryea C, Cousens S. 3.6 million neonatal deaths - what is progressing and what is not? Semin Perinatol. 2010;34(6):371-86.

Herrera E, Amusquivar E, Lopez-Soldado I, Ortega H. Maternal lipid metabolism and placental lipid transfer. Horm Res. 2006;65(Suppl 3):59-64.

Martin U, Davies C, Hayavi S, Hartland A, Dunne F. Is normal pregnancy atherogenic? Clin Sci. 1999;96(4):421-5.

Amundsen AL, Khoury J, Iversen PO, Bergei C, Ose L, Tonstad S, et al. Marked changes in plasma lipids and lipoproteins during pregnancy in women with familial hypercholesterolemia. Atherosclerosis. 2006;189(2):451-7.

Robertson WB, Brosens I, Dixon G. Maternal uterine vascular lesions in the hypertensive complications of pregnancy. Perspect Nephrol Hypertens. 1976;5:115-27.

Catov JM, Bodnar LM, Kip KE, Hubel C, Ness RB, Harger G, et al. Early pregnancy lipid concentrations and spontaneous preterm birth. Am J Obstet Gynecol. 2007;197(6):610.e1-7.

Kramer MS, Kahn SR, Rozen R, Evans R, Platt RW, Chen MF, et al. Vasculopathic and thrombophilic risk factors for spontaneous preterm birth. Int J Epidemiol. 2009;38(3):715-23.

Alleman BW, Smith AR, Byers HM, Bedell B, Ryckman KK, Murray JC, et al. A proposed method to predict preterm birth using clinical data, standard maternal serum screening, and cholesterol. Am J Obstet Gynecol. 2013;208(6):472.e1-11.

Stewart PJ, Nimrod C. The need for a community-wide approach to promote healthy babies and prevent low birth weight. Can Med Assoc J. 1993;149(3):281-5.

Engmann C, Walega P, Aborigo RA, Adongo P, Moyer CA, Lavasani L, et al. Stillbirths and early neonatal mortality in rural Northern Ghana. Trop Med Int Health. 2012;17(3):272-82.

Diallo FB, Diallo MS, Sylla M, Diaw ST, Diallo TS, Diallo Y, et al. Premature delivery: epidemiology, etiologic factors, prevention strategies [French]. Dakar Med. 998;43(1):70-3.






Original Research Articles