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June 25, 2019  
FIBROIDS1 NEWS: Feature Story

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  • Low Maternal Cholesterol and Preterm Birth

    Low Maternal Cholesterol Poses Risk for Preterm Birth


    October 29, 2007

    By: Laurie Edwards for Fibroids1

    Most of the time when cholesterol levels make the news, it is the higher numbers that garner headlines. However, a new study found that low cholesterol may actually increase the risk of preterm birth in pregnant women.
    Take Action
    The healthier you are, the healthier your baby will be. Here are proactive tips for preventing preterm birth:
  • Seek regular prenatal care and don’t be afraid to discuss any changes or symptoms you notice.
  • In addition to eating a healthy diet, take a daily prenatal vitamin to ensure your baby receives vitamins and minerals essential for development.
  • You may have to work fewer hours or limit physical activity if you develop symptoms of preterm labor. Discuss your activity and exercise levels with your physician and follow your prescribed guidelines.
  • Avoid smoking and drinking alcohol and always consult your physician before taking over the counter medications and supplements.
  • Women who experience vaginal bleeding or trouble with the cervix or placenta or other problems may not be able to have sex, so make sure you talk to your doctor if you have concerns.

  • The study, published in the October edition of Pediatrics, concluded that total serum maternal cholesterol measuring below the tenth percentile in the second trimester was the strongest predictor of preterm birth in otherwise low-risk white women.

    “We were surprised by the significant, four-fold increase of premature birth among white mothers and equally surprised that this finding was not confirmed among African American mothers,” said study author Dr. Maximilian Muenke of the National Human Genome Research Institute of the National Institutes of Health.

    However, babies born to women of both races with low cholesterol weighed, on average, 150 grams less than those born to women without low cholesterol, and were about twice as likely to have smaller head circumferences.

    A baby born before 37 weeks is considered preterm, and babies with a birth weight under five and a half pounds are classified as having low birth weight.

    This study and previous ones have also found an association between elevated maternal cholesterol – measuring 300 mg/dl and above – and preterm birth, prompting researchers to conclude that “the concept of an optimal range for maternal serum cholesterol during pregnancy may have merit.”

    The retrospective study found that preterm birth occurred in 12.7 percent of women whose cholesterol was below the tenth percentile – 159 mg/dl – while 5.0 percent of women whose cholesterol measured in the middle range gave birth prematurely.

    Given the function of cholesterol in fetal development, experts see the logic in the results.

    “Cholesterol is a building block for membranes, hormones and proteins, so it makes sense that if you have low cholesterol, your baby won't have the substrate it needs to grow,” said Dr. Robert Welch, chair of obstetrics and gynecology of St. John Health's Providence Hospital in Southfield, Mich.

    Likely, the lower cholesterol levels were caused by a combination of genetics and poorer nutrition. “These results could support the implementation of nutritional interventions among pregnant women to reduce the risk of preterm birth,” particularly in malnourished populations, wrote Mario Merialdi, M.D., Ph.D., of the World Health Organization, and Jeffrey Murray, M.D., of the University of Iowa in Iowa City, Iowa, in an editorial accompanying the study.


    More than half a million babies are born prematurely in the United States annually. While medical advances have resulted in lower incidences of certain diseases and conditions among newborns, the number of women who give birth prematurely or have babies with low birth weight has not decreased.

    The most common risk factors for preterm birth include: smoking and using illicit drugs, carrying twins or multiples, having certain chronic conditions like diabetes or hypertension, certain infections or problems with the cervix or placenta, being underweight prior to pregnancy, or stressful events like domestic violence or the loss of loved ones.

    This study has its place in the growing body of literature that explores preterm birth, but experts urge caution in interpreting its results. For one thing, the study was performed using a highly selective group of participants. For another, the average gestational age in these women – 17.6 weeks – cannot be applied to other populations with varying gestational risks. Experts also want to examine why there is such a discrepancy among races in terms of cholesterol levels and preterm birth.

    “At this point, the message is really to 'stay tuned' for a repeat study. In the meantime, talk with your obstetrician about a healthy lifestyle, including exercise and healthy nutrition,” said Muenke.

    Last updated: 29-Oct-07

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