Maternal plasma cholesterol and duration of pregnancy: A prospective cohort study in Ghana

Low plasma cholesterol may be associated with preterm birth; however, results are mixed and limited primarily to high-income countries. Our objective was to determine whether maternal plasma lipid concentrations are associated with pregnancy duration. We performed a nested cohort (n=320) study of pregnant Ghanaian women enrolled in a randomized controlled trial. Total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, and triglyceride concentrations were analyzed in plasma at ≤20and 36weeks gestation as continuous variables and also categorized into low, referent, or high (90th percentile). At ≤20weeks, plasma lipid concentrations were not associated with pregnancy duration. At 36weeks, total cholesterol and triglyceride concentrations were not associated with pregnancy duration. Higher HDL-C at 36weeks was associated with a longer pregnancy duration (adjusted β-coefficient±standard error: 0.05±0.02daysmg-1 /dL, p=.02); pregnancy duration was 5.9±2.0 (mean±standard error)days shorter among women with low HDL-C compared with the referent group (10th-90th percentile) (p=.02) and 8.6±2.6days shorter when compared with the high HDL-C group (p=.003). Pregnancy duration was 4.9±2.1days longer among women with low low-density lipoprotein cholesterol at 36weeks gestation when compared with the referent group (p=.051). Our data suggest that low HDL-C in the third trimester of pregnancy is associated with a shorter duration of pregnancy in this study population but do not support the hypothesis that low total cholesterol is associated with a shorter pregnancy duration.