Lipid profile in consecutive pregnancies

Abstract

Aim: To describe the lipid profile of women prior to, during and after pregnancy and to assess the effect of consecutive pregnancies on the plasma lipid profile.

Methods: Blood lipid levels of 1752 women aged 20-45 years who delivered between 1999 and 2005 were measured. The lipid profile included total cholesterol, LDL-C (Low density lipoprotein), HDL-C (High density lipoprotein-C), VLDL-C (Very low density lipoprotein) and triglycerides (TG). The measurements were classified into the following categories: non-pregnant state (12 months prior to conception), during the three trimesters of pregnancy and from 6 weeks to 12 months postpartum. This profile was tested in up to three subsequent pregnancies.

Results: Total cholesterol levels overall rose during pregnancy. In the first trimester there is an average decrease of 11.4 mg/dL in total cholesterol level (p < 0.0001) followed by an average increase of 50.5 mg/dL and 28 mg/dL in the second and third trimesters respectively (p < 0.0001). In the year after pregnancy, the levels return to pre- pregnancy levels. LDL and triglyceride levels show a similar pattern.In contrast, HDL-C levels do not change significantly in the first trimester. The second trimester is characterized by an average elevation of 14 mg/dL (p < 0.0001) and a decrease of 5 mg/dL in the third trimester (p = 0.03).The average HDL-C levels of every period tested were lower in the 2nd and 3rd subsequent pregnancies.

Conclusions: There is a general increase in total cholesterol, LDL and VLDL during pregnancy. We demonstrate a cumulative effect of consecutive pregnancies on lowering HDL cholesterol levels. This effect may have negative implications on future cardiovascular health.

Figure 1

Average lipid profile during pregnancy.

Figure 2

Average HDL cholesterol levels in subsequent pregnancies.