Association of lipid levels during gestation with preeclampsia and gestational diabetes mellitus: a population-based study

Abstract

Objective: The study evaluates lipids profile changes during gestation in pregnancies with and without preeclampsia and/or gestational diabetes.

Study design: Lipid profiles were assessed between year prior and after pregnancy in 9911 women without cardiovascular comorbidities.

Results: Lipid levels during gestation varied substantially with a nadir following conception and a peak at delivery. Compared to preconception levels total cholesterol levels increased from 164.4 mg/dL to 238.6 mg/dL and triglycerides (TGs) from 92.6 mg/dL to 238.4 mg/dL. The composite endpoint (gestational diabetes mellitus or preeclampsia) occurred in 1209 women (12.2%). Its prevalence increased with levels of TG-from 7.2% in the group with low TGs (<25th percentile adjusted for the gestational month) to 19.8% in the group with high TGs (>75th percentile), but was not associated with high-density lipoprotein levels. In multivariate analysis higher TGs levels, but not low high-density lipoprotein, were associated with the primary endpoint.

Conclusion: Lipid levels change substantially during gestation. Abnormal levels of TGs are associated with pregnancy complications.

FIGURE 1. Flowchart of the study population

^aIn case a woman had >1 pregnancy during the defined period, and ≥1 lipidograms, a gestation with the conception closest to the lipidogram date was chosen; ^bChosen at random from 52,815 deliveries during study period with no lipids analysis between 12 months prior to conception and 12 months following the delivery.

FIGURE 2. Levels of TC, TGs, HDL, and LDL 1 year before, during, and 1 year after gestation

Time 0 represents calculated conception date. Women with preeclampsia or gestational diabetes mellitus are excluded.

FIGURE 3. Levels of TC, TGs, LDL, and HDL during gestation and immediate postpartum period (2 months following the delivery)

Women with preeclampsia or gestational diabetes mellitus are excluded.

FIGURE 4. Levels of TC, TGs, LDL, and HDL during gestation and immediate postpartum period (2 months following the delivery)

A, Levels of triglycerides (TGs) and high-density lipoprotein (HDL) during pregnancy, adjusted for a gestational month and rate of pregnancy complications. B, Levels of HDL during pregnancy, adjusted for a gestational month and rate of pregnancy complications.