Maternal Lipid Profile in Preeclampsia: Case-Control Study

Abstract

Background: Preeclampsia has continued to be a challenge especially in the areas of understanding the pathogenesis and prevention or treatment of the disease. Previous reports on the relationship between maternal lipids and preeclampsia have varied as its role in the aetiopathogenesis of pre-eclampsia is not clearly defined. This study aimed at comparing the lipid profile in preeclampsia with that in normotensive pregnancy. It also examined for any relationship between an abnormal profile and severe disease. Methods: This was a prospective case-control study. It was conducted among pregnant women who presented for routine antenatal care and those seen in the emergency room of the obstetrics unit of a tertiary institution in Lagos, Nigeria.  The duration of the study was 6 months as it took place between May 2015 to October 2015. Pregnant women in their second half of pregnancy, diagnosed to have pre-eclampsia and, who gave consent were consecutively recruited as cases and pregnant women with similar age and gestational age, who had normal blood pressure were also selected as controls within the study period. The Maternal lipid profile was assayed using an enzyme-based assay kit and analysed according to the manufacturer’s instructions. All participants were followed up till delivery. Results: One hundred and seventy pregnant women in the third trimester of pregnancy participated in this study. They were within 18 – 45 years of age. More of the participants were nulliparous. Eighty-five of them had pre-eclampsia and constituted the study group while 85 were normotensive in the control group. The mean age was similar in both groups (control=29.59 ± 4.50 years versus pre-eclampsia=29.73 ± 5.10 years). The gestational ages at blood sampling of the patients in this study ranged between 27 – 40 weeks.  The analysis of data revealed that the level of total cholesterol, triglycerides, low-density lipoprotein and very-low-density lipoprotein was higher in the cases compared with the control. This difference was statistically significant because the calculated P-value was <0.05. The level of high-density lipoprotein was lower in those with pre-eclampsia. Serum cholesterol and low-density lipoprotein were significantly higher (P-value= 0.04) in those with severe disease. A significant positive relationship was observed between mean arterial blood pressure and abnormal levels of lipids. Conclusion: An abnormal pattern of lipid profile was observed in women with preeclampsia and this was more marked in those with severe disease. A larger multi-centre study will be required to substantiate this finding.