Effect of Maturity And Birth Weight On Umbilical Cord Blood Lipid Profile: A Fetal Programming Phenomenon

ABSTRACT

Background:The recent research on "fetal programming hypothesis" has totally revived the mechanistic understanding of triggering factors responsible for development of cardiovascular diseases (CVDs). As deranged lipid profile is associated with increased predisposition to atherosclerotic CVDs, we planned to study effect of fetal maturity and birth weight on umbilical cord blood lipid profile. Methods: A hospital based cross sectional study including 200 neonates satisfying inclusion criteria was carried out. The umbilical cord blood samples of selected neonates were collected and analysed for lipid profile (Total Cholesterol (TC), Triglycerides (TG), High Density Lipoprotein Cholesterol (HDL-C), Low Density Lipoprotein Cholesterol (LDL-C) and Very Low Density Lipoprotein Cholesterol (VLDL-C)) in order to be compared among groups of neonates based on maturity and birth weight. Results: The preterm neonates had statistically significant higher levels of umbilical cord blood TC, TG, LDL-C and VLDL-C (with P values of 0.025, 0.001, 0.045, 0.007 and 0.045 respectively) while lower but statistically insignificant (p value of 0.131) levels of HDL-C in as compared to full term neonates. The low birth weight neonates also had statistically significant higher levels of TC, TG, LDL-C and VLDL-C (P values of 0.001, 0.032, 0.00001 and 0.032 respectively) but statistically significant (P value of 0.034) lower levels of HDL-C in umbilical cord blood as compared to normal birth weight neonates. Conclusion: The results suggest that prematurity as well as low birth weight have deleterious effect on umbilical cord blood lipid profile resulting in more atherogenic lipid levels. This could be regarded a triggering factor responsible for development of CVDs in later life. This observation not only conciliates with fetal programming hypothesis but also indicates that its effect is evident (in the form of altered lipid profile) even at the birth in such programmed neonates.