Abstract:
Objective: Increased rates of pro-inflammatory and
metabolic-related disorders, plus perinatal death and other pregnancy
complications such as gestational diabetes (GDM), are consistently
reported among women of Indian ethnicity. This study compares lipid
profiles and early pregnancy biomarkers associated with metabolic
dysfunction between healthy nulliparous pregnant women of Indian and
European ethnicity.
Design: a prospective cohort study.
Setting: Australia, Ireland, New Zealand and the United Kingdom;
2004-2011.
Population: 138 and 5,240 women of Indian and European ethnicity
were included from the prospective Screening for Pregnancy Endpoints
cohort study.
Methods: Early pregnancy biomarkers were selected a priorion the basis of a potential association with the metabolic syndrome,
diabetes/GDM or obesity, and compared between ethnic groups. Biomarkers
that differed significantly between ethnic groups were adjusted for
maternal age, body mass index, smoking, alcohol use and socioeconomic
status.
Main outcome measures: Mean values for 21 placental, metabolic,
inflammatory and cardiovascular biomarkers, plus blood lipids, measured
at 15±1 weeks gestation.
Results: Ten biomarkers were significantly different by
ethnicity, mostly consistent with a pro-inflammatory and less favourable
metabolic profile in Indian women: PlGF (p=0.02), adiponectin
(p<0.01), NGAL (p<0.01), TNFR1A (p<0.01),
CXCL10 (p=0.01), ICAM-1 (p<0.01), ST2 (p<0.01),
angiogenin (p<0.01), and proANP (p<0.01). We
additionally found increased triglycerides (1.6±0.6 vs 1.5±0.6,
p<0.01) and reduced HDL cholesterol (1.7±0.4 vs 1.9±04,
p<0.01) in Indian mothers, compared with European.
Conclusions: Low-risk mothers of Indian ethnicity have an overall
less favourable metabolic health profile at early gestation compared
with European women. Future research should investigate the association
with pregnancy outcomes.