The Impact of Maternal Obesity and Gestational Weight Gain on Early and Mid-Pregnancy Lipid Profiles

OBJECTIVE The impact of maternal overweight/obesity and excessive weight gain on maternal serum lipids in the first and second trimester of pregnancy was evaluated. METHODS Prospective data were collected for 225 women. Maternal serum lipids and fatty acids were measured at <13 weeks and between 24 and 28 weeks. Analyses were stratified by normal weight versus overweight/obese status and excessive versus nonexcessive weight gain. RESULTS Overweight/obese women had higher baseline cholesterol (161.3 ± 29.6 vs. 149.4 ± 26.8 mg/dl, P < 0.01), low-density lipoprotein LDL (80.0 ± 19.9 vs. 72.9 ± 18.8 mg/dl, P < 0.01), and triglycerides (81.7 ± 47.2 vs. 69.7 ± 40.3 mg/dl, P = 0.05) when compared to normal weight women, whereas high-density lipoprotein (43.6 ± 10.4 vs. 47.6 ± 11.5 mg/dl, P < 0.01) was lower. However, cholesterol and LDL increased at a higher weekly rate in normal weight women, resulting in higher total cholesterol in normal weight women (184.1 ± 28.1 vs. 176.0 ± 32.1 mg/dl, P = 0.05) at 24-28 weeks. The rate of change in lipid profiles in either group was not affected by excessive weight gain. Overweight/obese women had higher levels of arachidonic acid at both time points. CONCLUSIONS Overweight/obese women have significantly more atherogenic lipid profiles than normal weight women during the period of early pregnancy, delineating one physiologic pathway between that could explain differences in pregnancy outcomes normal weight and overweight/obese women.