Hypertriglyceridemia and adverse outcomes during pregnancy

Abstract

Introducción. Durante el embarazo, los niveles séricos de triglicéridos maternos aumentan como un mecanismo de adaptación fisiológica para suplir las necesidades del feto en desarrollo. Pese a que el incremento excesivo se ha asociado a preeclampsia, macrosomía y parto pretérmino, no se han establecido de manera contundente los niveles a partir de los cuales se deben tomar medidas en cada trimestre para prevenir complicaciones.Objetivo. Hacer una revisión sobre fisiopatología, efectos en madre e hijo, valores esperados en cada trimestre e intervenciones terapéuticas en hipertrigliceridemia gestacional.Materiales y métodos. Se realizó una revisión con la búsqueda de artículos en las bases de datos ScienceDirect, PubMed, Scopus, LILACS, Cochrane y SciELO con los términos: Pregnancy; Hypertriglyceridemia; Maternal-Fetal Exchange; Fetal Development; Pregnancy Complications y sus equivalentes en español.Resultados. Se encontraron 59 artículos que cumplieron los criterios de búsqueda y daban respuesta a los objetivos.Conclusiones. El número limitado y la gran variabilidad de los datos indican la necesidad de realizar más investigaciones que establezcan los rangos de normalidad de los triglicéridos durante los tres trimestres del embarazo y así determinar riesgos e intervenciones eficaces antes de la gestación y reducir la morbimortalidad materno-infantil.

Assessment of Serum Lipid and Uric Acid Levels in Women with Normal Pregnancy and Pre-Eclampsia

“…Hypertriglyceridemia result in an oxidative environment leading to endothelial injury predisposing to pre-eclampsia. Furthermore, it may predispose the baby born from mother suffering from pre-eclampsia to metabolic and cardiovascular disorders in adulthood 22 . A study conducted in Egypt on cohort of n=251 pregnant women demonstrated the TG levels as predictor of pre-eclampsia between 4-12 weeks of pregnancy.…”

Vitamin D status and vitamin D deficiency risk factors among pregnancy of Shanghai in China

“…Gestation is characterized by increased serum levels of total cholesterol and triglycerides pushed by estrogen, progesterone, and lactogen, which mobilize stored fat depots in late pregnancy, a pool of fatty acids for foetal growth, and placental tissue steroid synthesis. This physiologic increase in lipids performs an essential role during pregnancy; however, elevated lipids in susceptible women or familiar forms of hyperlipemia can increase maternal-foetal complications [ 41 ], and gestational hyperlipemia is associated with preeclampsia, preterm birth, and gestational diabetes, and offspring of these mothers show a propensity to enhanced fatty streak formation and an increased risk of progressive atherosclerosis [ 42 ]. It was previously demonstrated that chronically fructose-fed with diets containing high percentages of fructose develop hyperlipemia [ 43 ] and insulin resistance in pregnancy [ 44 ].…”

Hypertriglyceridemia triggered acute pancreatitis in pregnancy – diagnostic approach, management and follow-up care

“…The fetus from an AP pregnancy is exposed to the risk of threatened preterm labor, prematurity and death [7,43,44]. Regarding the follow-up of fetuses from hyperlipidemic patients, results of pathology studies performed on 6-month-old deceased fetuses of mothers with hypercholesterolemia compared to mothers with normal cholesterol levels revealed the presence of fatty streaks at aortic level [45,46].…”