Small for gestational age and lipid parameters during the first 14-16 months of life

Aim A lipid profile with high concentrations of apolipoprotein B-containing lipoproteins - non-high-density lipoprotein (HDL)-cholesterol - is a causal risk factor for atherosclerotic cardiovascular disease. Accumulation of these lipoproteins is cumulative over the lifespan and high concentrations in childhood are associated with high concentrations later in life. Recently, we described developments of lipid traits in early childhood, and showed that sex, gestational age, and breastfeeding are influencing factors. Whether small for gestational age (SGA) – a state with an unfavorable metabolic profile – influences lipid traits in early life is however unknown. Methods For this purpose, we used the Copenhagen Baby Heart Study comprising 13,354 umbilical cord blood samples and parallel venous blood samples from children and parents at birth (n=444), at two months (n=363), and at 14-16 months (n=158). All lipid traits were measured in mmol/L. Results In cord blood, medians (25th-75th percentiles) for small, appropriate, and large for gestational age newborns were 0.98 (0.81-1.18), 0.95 (0.77-1.15), and 0.92 (0.72-1.15) for non-HDL-cholesterol, 0.22 (0.17-0.31), 0.18 (0.13-0.23), and 0.14 (0.11-0.20) for remnant cholesterol, 0.50 (0.37-0.68), 0.39 (0.29-0.51), and 0.32 (0.25-0.44) for triglycerides, and 0.62 (0.46-0.79), 0.73 (0.58-0.91), and 0.78 (0.62-0.96) for HDL-cholesterol (all p-values<0.0001). For total cholesterol and LDL-cholesterol no differences were found according to size for gestational age. SGA newborns of mothers with preeclampsia had the highest concentrations of non-HDL-cholesterol, remnant cholesterol, and triglycerides. Similar differences according to size for gestational age were also found in venous blood samples at birth, at two months, and at 14-16 months. Conclusion SGA newborns have higher concentrations of atherogenic non-HDL-cholesterol and remnant cholesterol. These differences between small, appropriate, and large for gestational age observed early in life may suggest increased risk of atherosclerotic cardiovascular disease later in life.