Complications of Hypertriglyceridemia in Pregnancy and Its Impact on Neonates: a Hospital-Based Study From Odisha

Abstract

Objective Hypertriglyceridemia (HTG) in pregnancy causes an increased risk for maternal and fetal complications. But, reports on the impact of HTG in pregnancy on maternal and fetal outcomes are scarce in developing countries. We aim to determine the maternal and neonatal complications of HTG in pregnancy. Materials and methods This prospective observational study was conducted on 150 pregnant women with HTG in the department of obstetrics and gynecology, KIMS, Bhubaneswar, from December 2019 to November 2020. Measurement of triglycerides during the first trimester, second trimester, and delivery was done. Maternal complications and neonatal outcomes in HTG mothers and mothers with normal triglyceride levels were compared. Results Out of 150 HTG cases, hypothyroidism, preeclampsia, acute pancreatitis, and sickle cell crisis occurred in 41 (27.3%), 22 (14.7%), six (4%), and three (2%) cases, respectively. The triglyceridemia (TG) levels raised from 133.7±48.2 mg/dl in the first trimester to 232.8±151.0 mg/dl in the third trimester. There is a significant increase in TG levels at the time of delivery compared to the first and second trimesters (p< .001). Out of 140 neonates, 30 (21.4%) were preterm, eight (5.7%) had intrauterine growth restriction (IUGR), and four (6.06%) were macrosomic. Intrauterine death, preterm, and macrosomia are significantly associated with maternal HTG compared to normal mothers (p < .032). All mortalities were due to acute pancreatitis (6; 4%) among mothers and four intrauterine fetal death. Conclusion There is a steady increase in TG levels in the successive trimesters of pregnancy. Gestational severe hypertriglyceridemia causes life-threatening complications. HTG-induced acute pancreatitis needs to be managed aggressively to prevent maternal death. Neonates of HTG mothers suffer from complications like prematurity, IUGR, and macrosomia.

Approach to the Management of Hypertriglyceridemia Complicated With Acute Pancreatitis in Pregnancy: A Case Report

“…Some women with a genetic predisposition or an additional triggering condition may experience severe gestational hypertriglyceridemia. It can lead to numerous life-threatening consequences, such as AP [ 7 ].…”

“…Moreover, in laboratory investigations, it was discovered that fatty acids cause damage to the mitochondria as a result of high levels of TGs in the blood. The ischemia-induced acidic environment exacerbates the toxicity of the FFAs leading to heightened pancreatic damage [ 7 ].…”

Assessment of the Risk of Future Metabolic Syndrome among Non-Hypertensive and Non-Diabetic Nigerian Pregnant Women Presenting with either Glycosuria or Proteinuria at Different Trimesters

“…Elevated triglyceride in pregnancy has been reported to cause complications in both the mother and fetus. [26,27] An elevated triglycerides in pregnancy has been related to greater threat of preeclampsia to the woman and other complications to the fetus. [28] In addition, elevated triglycerides is associated with an increased risk of future type 2 diabetes mellitus.…”