Date of Award
5-26-2016
Document Type
Dissertation
Degree Name
Master of Medicine (MMed)
First Supervisor/Advisor
Prof. Marleen Temmerman
Second Supervisor/Advisor
Dr. Alfred Murage
Third Supervisor/Advisor
Dr. Mwaniki Mukaindo
Department
Obstetrics and Gynaecology (East Africa)
Abstract
Introduction: The association of neonatal birth weight and mid-term maternal lipid levels has been demonstrated in several studies with elevated serum triglyceride levels shown to be a strong predictor of the large for gestational age baby/ fetal macrosomia. Maternal diabetes remains the strongest risk factor for developing a LGA/macrosomic baby explained by the Pederson hypothesis. However non-diabetic macrosomia is still an obstetric dilemma with the attendant fetal and maternal complications. This phenomenon could be explained by altered maternal lipid metabolism as lipids have been shown to be important for normal fetal growth and development.
Objective: Our primary objective was to determine the association of maternal triglyceride level and neonatal birth weight.
Methods: Population: Non-diabetic healthy women with singleton pregnancies between 24-32wks.
Design: Prospective cohort study.
Outcome of interest: Our primary outcome of interest was neonatal birthweight. Giving birth to a large for gestational age baby was our secondary outcome of interest.
Analysis: Pearson correlation coefficient and regression analysis was done to assess association between our variables of interest.
Results: We demonstrated a positive linear association between fasting maternal triglyceride levels and neonatal birthweight (r=0.27). Stepwise multiple linear regression demonstrated maternal TG to be an independent predictor of neonatal birthweight (β=164(26-302). In stepwise logistic regression, there was a trend for hypertriglyceridaemia being an independent predictor of birth to a large for gestational age baby though not statistically significant (OR 4.69(0.72-30.59), P=0.106).
Conclusions: Fasting maternal triglyceride is associated with neonatal birthweight and is an independent predictor of neonatal birthweight even after adjusting for gestation at delivery and history of macrosomia in healthy non diabetic women.
Though not statistically significant there was a trend for maternal hypertriglyceridaemia being a predictor of birth to a large for gestational age baby.
Recommendations: A large prospective cohort study based on triglyceride levels should be undertaken to assess the risk of having high TG and delivering a macrosomic/LGA baby.
Recommended Citation
Omondi, D. M. (2016). Association of 24-32wk maternal triglyceride levels and neonatal birth weight at the Aga Khan University Hospital (Unpublished master's dissertation). Aga Khan University, East Africa.