Introduction
Gestational lipids increase throughout pregnancy as a physiological response to adapt gestation.1 TG level increased significantly from the first trimester to the third trimester contributing to maternal energy storage and fetal growth.2 However, dyslipidemia in pregnancy is closely associated with the development of pregnancy complications such as GDM,3 hypertensive disorders of pregnancy (HDP)4 and intrahepatic cholestasis of pregnancy (ICP).5 Elevated TG level can lead to hypertriglyceridemia,6 which is one of the most severe dyslipidemia and has been proved to cause cardiovascular disease and metabolic disorders.7-9 However, threshold of gestational TG level and the postpartum outcome of the TG elevation during gestation is unclear.
Puerperium refers to the period of time that organs and systems of puerpera require to return to or approach a normal state of non-pregnancy, usually lasts 42 days. Therefore, blood lipid test at 42 days postpartum is of great significance to evaluate the recovery of puerpera and predict the risk of future disease. It was found that the prevalence of postpartum dyslipidemia in women with GDM was significantly higher than non-GDM women, which suggested the importance to explore the association between lipid levels during pregnancy and postpartum.10
Many factors affect serum lipids levels. For pregnant women, pre-BMI is a major threat. Studies have found that overweight and obese pregnant women have higher TG level than normal women throughout gestation.11 But it is not clear whether the effect of pre-BMI on gestational TG will continue to postpartum.
This prospective study aimed to characterize changes in serum TG level from pregnancy to postpartum and investigate the association of gestational TG with the risk of postpartum hypertriglyceridemia; also to select TG cutoff points of each gestational week; moreover, we investigated whether pre-BMI or GDM affects such an association.