Lipid levels to predict pregnancy complications
Pregnancy complications such as pre-eclampsia are a result of the metabolic syndrome and its manifestations. Among these, insulin resistance and hypertriglyceridemia are major contributors to the development of endothelial dysfunction. However, little information is available on lipid physiology and pathophysiology during pregnancy and how they could lead to elevated triglycerides and/or low high-density lipoprotein (HDL) levels, a manifestation known as dyslipidemia. Previous findings suggested that elevated levels of triglycerides during pregnancy were associated with increased risk for pre-eclampsia and gestational diabetes mellitus. In addition, women with pre-eclampsia and gestational diabetes continued to have higher levels of lipids after giving birth. With these in mind, scientists of the EU-funded project PREDICT (Evaluation of lipid levels prior and during gestation and association with adverse pregnancy outcomes and subsequent development of true dyslipidemia. Population based study) set out to evaluate lipid homeostasis from pre-conception, throughout the gestational period and up to three years after birth in a large cohort of women. For this purpose, they performed a retrospective analysis of over 27 000 women with no previous indications of cardiovascular morbidity, pre-eclampsia and gestational diabetes mellitus. Overall, pre-eclampsia or gestational diabetes was diagnosed in 11 % of these women. Results showed an increased rate of pre-eclampsia and/or gestational diabetes in women with low HDL levels and high triglycerides before conception. Taken together, the findings of the PREDICT study underscore a role for lipid homeostasis during pregnancy and warrant the screening of lipid levels in women of child-bearing age. Implementation of a routine lipid test should help predict pregnancy complications and take appropriate measures to minimise them.
Keywords
Lipid levels, pregnancy, pre-eclampsia, gestational diabetes mellitus, PREDICT
