association between elevated serum free fatty acids in the third trimester of pregnancy and preterm delivery

Preterm delivery is not only an important cause of neonatal morbidity and mortality, but also its long term effect causes severe problems for the off spring and for the mother. We conducted a case control study to evaluate the association between elevated serum total free fatty acids [FFAs] in the third trimester of pregnancy and the incidence of preterm delivery. Twenty preterm [gestational age 28-34 weeks] and 20 control women [gestational age>37 weeks] registered to El Shatby Maternity University Hospital were evaluated. Preterm delivery was based on ultrasonographic assessment of cervical length less than 2.5 cm and cervical dilatation>10mm in primigravida and 20-30 mm in multigravida. Evaluation of serum fasting FFAs in the third trimester was done for cases of preterm delivery and their matched controls of term delivery. Also, pregnancy complications of foetal birth weight and incidence of admission to neonatal intensive care unit were assessed. Data were gathered from women who delivered in addition to their caring obstetricians involved as well as reviewing their medical records. The mean level of FFAs was significantly elevated in preterm cases compared to term control [442.3 +/- 51.47, 315.15 +/- 69.14 respectively, P=0.001]. Women with high levels of serum FFAs had more than two folds increased risk for preterm delivery OR [2.5], 95% [CI] 1.2-2.4, p<0.001. Also, high FFAs levels were associated with increased incidence of neonatal admission to Neonatal Intensive Care Unit. This study suggests that elevated total serum FFAs during the third trimester of pregnancy might be a predisposing factor for preterm delivery in non obese uncomplicated pregnant women. Also, these changes of maternal lipid metabolism may influence FFAs delivery to the foetus that can affect foetal growth