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Subject Area

Obstetrics and Gynecology

Article Type

Original Study

Abstract

Objectives To evaluate the relationship between maternal serum lipids at late gestation in nondiabetic women and the risk of large for gestational age (LGA) and neonatal macrosomia. Background LGA is defined as an infant with a birth weight greater than the 90th percentile for the given week of pregnancy. Maternal dyslipidemia can also induce excessive fetal growth by changes in lipid metabolism during pregnancy. Patients and methods A prospective observational study was conducted on 161 pregnant women aged 20–35 years recruited from the Department of Obstetrics and Gynecology of Menoufia University Hospital and Shebin El-Kom Teaching Hospital from January 2020 till December 2020. The patients included in the study were singleton live pregnancy, pregnant at 37–42 gestational weeks, and naturally conceived. For all patients, detailed history taking, including family history of diabetes mellitus among first-degree relatives, complete clinical examination, and measurements of maternal lipid profile, including total cholesterol, triglyceride (TG), high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol (LDL-C), and fasting blood sugar and 2 h postprandial blood sugar, were done. Obstetric ultrasound was performed to assess fetal growth. Accordingly, patients were classified into three groups as follows: group 1, normal group; group 2, LGA; and group 3, LGA and neonatal macrosomia. Results Our results reported that cholesterol level, TG, LDL levels, and fasting blood sugar level were significantly higher in the LGA group when compared with the normal group. These significant higher levels were consistent between the neonatal macrosomic group and the normal group, with the exception of LDL level, which showed a nonsignificant difference. A cutoff level of cholesterol more than 214 has a sensitivity of 93.8%, a specificity of 82.2%, and an accuracy of 85%, whereas a cutoff level of TG more than 244 has a sensitivity of 96.6%, a specificity of 55.3%, and an accuracy of 63%. Conclusions Elevated TG and cholesterol at late gestation are independent predictors for LGA and neonatal macrosomia in nondiabetic pregnant women.

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