Brief overview of maternal triglycerides as a risk factor for pre‐eclampsia

Abstract

Background Features of the metabolic syndrome-maternal obesity, diabetes mellitus and chronic hypertension-are risk factors for pre-eclampsia.Objectives To determine the risk of pre-eclampsia in the presence of maternal hypertriglyceridemia, another major element of the metabolic syndrome.Search strategy Two investigators independently searched PubMed and Embase databases from 1980 to December 2004 for relevant studies. The terms preeclampsia, eclampsia, pregnancyinduced hypertension or toxemia were combined with dyslipidemia, hyperlipidemia, hypertriglyceridemia, lipids, cholesterol, triglycerides (TG) or lipoprotein.Selection criteria We included case-control and cohort studies published in English that included at least 20 women with preeclampsia and that sampled serum or plasma TG at any time before, during or after pregnancy.Data collection and analysis Mean maternal TG concentrations were compared between cases and controls within each study. The odds ratio of pre-eclampsia was calculated by comparing the risk of pre-eclampsia among women in each higher TG concentration category with that in the lowest reference category.Main results A total of 19 case-control and 3 prospective cohort studies were included. In 14 studies, the mean TG concentration was significantly higher among pre-eclamptic cases than among unaffected controls; in seven other studies, there was a nonsignificant trend in the same direction. The risk of preeclampsia typically doubled with each increasing TG category. In the four studies that adjusted for potential confounders, such as maternal age, parity and body mass index, there was about a fourfold higher risk of pre-eclampsia in the highest relative to the lowest TG category.Author's conclusions There exists a consistent positive association between elevated maternal TG and the risk of pre-eclampsia. Given that maternal hypertriglyceridemia is a common feature of the metabolic syndrome, interventional studies are needed to determine whether pre-pregnancy weight reduction and dietary modification can lower the risk of pre-eclampsia.

Effect of Pregnancy on the Lipid Profile in Egyptian Women

“…In our study there was significant fall in LDL-C level in 3 rd trimester of normal pregnancy, this result is in accordance with Jayanta et al, (10) which stated that this decrease in LDL-C could be explained by hyperestrogenaemia. In our study the serum triglycerides level increased starting from the 1 st trimester with highly significant elevation by the 2 nd trimester and increased markedly by the 3 rd trimester.These results are in agreement with Chiang et al, (11) & Ray et al, (12) who showed that the most dramatic damage in the lipid profile in normal pregnancy is serum hypertriglyceridemia, which may be as high as two to three folds in the third trimester over the levels in nonpregnant women. The principle modulator of this hypertriglyceridemia is estrogen as pregnancy is associated with hyperoestrogenaemia.…”

The ‘beneficial’ adipokines in reproduction and fertility

“…59 Obesity is a risk factor in preeclampsia, 59 as is the metabolic syndrome. 60 More pertinent to this discussion, there is genomic evidence that the condition is associated with one of the same polymorphisms of the adiponectin gene, SNP276, that correlates with ovarian disorders. 61 The few studies showing that circulating profiles of adiponectin vary through human gestation are contradictory.…”

Predictors of Preeclampsia in Women in the Metformin in Gestational Diabetes(Mig) Study

“…Abnormal lipids, in particular higher triglycerides and increased lipid peroxidation, are possibly involved in the pathogenesis of PE through endothelial dysfunction [24][25][26]. A metaanalysis of 19 case-control and 3 cohort studies showed a rising risk of PE with increasing triglycerides, at the time of PE, preceding PE diagnosis and postpartum [27]. A large retrospective database study of 9911 women found an association between an increase in triglycerides and a higher risk of PE, but did not find any association between HDL-C and PE [28].…”