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Review
. 2024 Jun 1;35(3):133-140.
doi: 10.1097/MOL.0000000000000927. Epub 2024 Feb 21.

Lipid metabolism during pregnancy: consequences for mother and child

Janneke W C M Mulder  1 , D Meeike Kusters  2 , Jeanine E Roeters van Lennep  1 , Barbara A Hutten  3   4
Affiliations
Review

Lipid metabolism during pregnancy: consequences for mother and child

Janneke W C M Mulder et al. Curr Opin Lipidol. .

Abstract

Purpose of review: Accommodating fetal growth and development, women undergo multiple physiological changes during pregnancy. In recent years, several studies contributed to the accumulating evidence about the impact of gestational hyperlipidemia on cardiovascular risk for mother and child. This review aims to provide a comprehensive overview of the current research on lipid profile alterations during pregnancy and its associated (cardiovascular) outcomes for mother and child from a clinical perspective.

Recent findings: In a normal pregnancy, total and LDL-cholesterol levels increase by approximately 30-50%, HDL-cholesterol by 20-40%, and triglycerides by 50-100%. In some women, for example, with familial hypercholesterolemia (FH), a more atherogenic lipid profile is observed. Dyslipidemia during pregnancy is found to be associated with adverse (cardiovascular) outcomes for the mother (e.g. preeclampsia, gestational diabetes, metabolic syndrome, unfavorable lipid profile) and for the child (e.g. preterm birth, large for gestational age, preatherosclerotic lesions, unfavorable lipid profile).

Summary: The lipid profile of women during pregnancy provides a unique window of opportunity into the potential future cardiovascular risk for mother and child. Better knowledge about adverse outcomes and specific risk groups could lead to better risk assessment and earlier cardiovascular prevention. Future research should investigate implementation of gestational screening possibilities.

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Conflict of interest statement

J.M. and D.M.K. report none. J.R.V.L. received a research grant from Novartis paid to the institution. B.A.H. received a research grant from Silence Therapeutics paid to the institution.

Figures

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Graphical abstract
Box 1
Box 1
no caption available
FIGURE 1
FIGURE 1
Relative changes in lipids during preconception (reference) and pregnancy. a During an active pregnancy wish, women with familial hypercholesterolemia (FH) are currently advised to discontinue lipid-lowering therapy. In pregnancy, women with and without FH undergo physiological changes in lipid metabolism. This results in comparable relative changes in lipid levels [8]. However, the absolute increase in mmol/l (or mg/dl) in women with FH will be larger since they start pregnancy already with a higher total and LDL-cholesterol level prior to pregnancy.
FIGURE 2
FIGURE 2
(a) Low-density lipoprotein cholesterol levels during pregnancy in women with and without FH. (b) Schematic representation of possible impact of gestational lipid profile on cholesterol burden in women with and without familial hypercholesterolemia.
See this image and copyright information in PMC

References

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