Introduction and Objective: The role of maternal lipids, especially triglycerides (TG), in contributing to excess fetal fat accretion in pregnancies affected by obesity or diabetes is of increasing interest, given supportive data in obesity. Outside of pregnancy, fasting TG (FTG) are reported as higher on Mondays, after the weekend. No such data exists in pregnancy. We characterized the daily variation of FTG throughout gestation, made possible by an FDA-approved portable point-of-care (POC) meter.Methods: In a prospective study designed to discern the role of TG in fetal fat accretion, at 15.1±1.1 wks’ gestation, 63 pregnant patients (pre-pregnancy BMI 31.8±3.6, age 30.9±4.6) used a TG meter to measure FTG for 4 consecutive days (≥7hr fast) on an ad libitum diet (N=242 FTG measures). FTG were repeated at 22 (N=196), 28 (N=183), and 34 wks (N=170). At each gestational age, the mean daily difference was assessed using the day of the week with the lowest mean FTG as a reference. Data are mean ± SD.Results: As expected, FTG increased significantly with each gestational period (mean FTG 137±55, 158±60, 183±60, and 228±69 mg/dL, respectively (p<0.001). At 15wks, FTG were lowest on Monday (125±60 mg/dL) and up to 23.7% higher on other days; at 22 wks, FTG were lowest on Saturday (150±41) and up to 13.7% higher; at 28 wks, FTG were lowest on Saturday (172±65) and up to 25.4% higher; and at 34 wks, FTG were lowest on Monday (207±74) and up to 32.0% higher on other week days.Conclusion: Characterization of 791 FTG across gestation demonstrates a 15-20% increase in FTG every ~6 wks, and an overall increase of ~67% from 15 to 34 wks’. However, unlike in the non-pregnant population, there is not consistent weekday variance suggesting less daily diet variation in pregnancy. These data support the substantial stepwise increase in FTG over gestation. Measures of FTG in pregnancy may be appropriate without significant concern for weekday variance, important when investigating the role of TG in fetal overgrowth.
E.Z. Dunn: None. L.A. Barbour: None. K.P. Rolloff: None. E. Phillips: None. C. Ingram: None. J. Hinojosa: None. E.M. Lopez: None. S. Pierce: None. J.E. Friedman: None. T.L. Hernandez: Research Support; Dexcom, Inc., PTS Diagnostics.
National Institutes of Health (5R01HD102726-02)
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