Advertisement

The hyperlipidemia of pregnancy in normal and complicated pregnancies

  • Julia M. Potter
    Correspondence
    Reprint requests: Dr. Julia M. Potter, Department of Pharmacology, The Queen Elizabeth II Medical Centre, Nedlands, Western Australia 6009.
    Affiliations
    Department of Clinical Science, John Curtin School for Medical Research, The Australian National University, Canberra, Australia
    Search for articles by this author
  • Author Footnotes
    * Present address: Baker Medical Research Institute, Commercial Road, Prahran, Victoria, Australia 3181.
    Paul J. Nestel
    Footnotes
    * Present address: Baker Medical Research Institute, Commercial Road, Prahran, Victoria, Australia 3181.
    Affiliations
    Department of Clinical Science, John Curtin School for Medical Research, The Australian National University, Canberra, Australia
    Search for articles by this author
  • Author Footnotes
    * Present address: Baker Medical Research Institute, Commercial Road, Prahran, Victoria, Australia 3181.
      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      Alterations in the concentrations of the cholesterol and triglyceride moieties of lipoproteins separated by ultracentrifugation and precipitation methods were studied at frequent intervals throughout pregnancy and the puerperium in a group of 43 women. The plasma cholesterol concentration rose on the average by about 50 per cent, the major increase occurring in the second trimester. The plasma triglyceride concentration rose threefold, reaching its peak during the third trimester. All major lipoproteins participated in these changes: in very-low-density lipoproteins, both lipids rose in proportion to the ratio in nonpregnant women, but in low-density and high-density lipoproteins, the ratio of triglyceride to cholesterol rose. The triglyceride enrighment in low-density lipoproteins reflected the inclusion of intermediate-density lipoproteins (d 1.006 to 1.019). The occurrence of hypertension or pre-eclampsia led to a further increase in lipids in very-low-density lipoproteins. Hypercholesterolemia was greatest in women with pre-existing hypercholesterolemia, and women in the third pregnancy showed higher plasma cholesterol concentrations than women in the first pregnancy. Both cholesterol and triglyceride concentrations decreased significantly within 24 hours of delivery and this was reflected in all lipoproteins. However, while triglyceride levels continued to decrease rapidly returning to nonpregnant levels during the puerperium, cholesterol in low-density lipoprotein remained elevated for at least six to seven weeks post partum.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Obstetrics & Gynecology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      Reference

        • Oliver M.F.
        • Boyd G.S.
        Plasma lipid and serum lipoprotein patterns during pregnancy and puerperium.
        Clin. Sci. 1955; 14: 15
        • de Alvarez R.R.
        • Gaiser D.F.
        • Simkins D.M.
        • Smith E.K.
        • Bratvold G.E.
        Serial studies of serum lipids in normal human pregnancy.
        Am. J. Obstet. Gynecol. 1959; 77: 743
        • Konttinen A.
        • Pyörälä T.
        • Carpén E.
        Serum lipid pattern in normal pregnancy and pre-eclampsia.
        Br. J. Obstet. Gynaecol. 1964; 71: 453
        • Knopp R.H.
        • Warth M.R.
        • Carrol C.J.
        Lipid metabolism in pregnancy. I. Changes in lipoprotein triglyceride and cholesterol in normal pregnancy and the effects of diabetes mellitus.
        J. Reprod. Med. 1973; 10: 95
        • Watson W.C.
        Serum lipids in pregnancy and the puerperium.
        Clin. Sci. 1957; 16: 475
        • Patelakis S.N.
        • Cameron A.H.
        • Davidson S.
        • Dunn P.M.
        • Fosbrooke A.S.
        • Lloyd J.K.
        • Malins J.M.
        • Wolff O.H.
        The diabetic pregnancy. A study of serum lipids in maternal and umbilical cord blood and of the uterine and placental vasculature.
        Arch. Dis. Child. 1964; 39: 334
        • Pantelakis S.N.
        • Fosbrooke A.S.
        • Lloyd J.K.
        • Wolff O.H.
        The Nature and occurrence of pre-betalipoprotein in diabetic children and pregnant women. An electrophoretic and ultracentrifugal study of serum lipoproteins.
        Diabetes. 1964; 13: 153
        • Hill L.
        • Schonfeld G.
        • Miller J.P.
        • Wulff G.
        Apolipoproteins in human pregnancy.
        Metabolism. 1975; 24: 943
        • Boyd E.M.
        Lipemia of pregnancy.
        J. Clin. Invest. 1934; 13: 347
        • de Alvarez R.R.
        • Bratvold G.E.
        Serum lipids in pre-eclampsia-eclampsia.
        Am. J. Obstet. Gynecol. 1961; 81: 1140
        • Nelson G.H.
        • Zuspan F.B.
        • Mulligan L.T.
        Defects of lipid metabolism in toxemia of pregnancy.
        Am. J. Obstet. Gynecol. 1966; 94: 310
        • Havel R.J.
        • Eder H.A.
        • Bragdon J.H.
        Distribution and chemical composition of ultra-centrifugally separated lipoproteins in human serum.
        J. Clin. Invest. 1955; 34: 1345
        • Fredrickson D.S.
        • Levy R.I.
        • Lees R.S.
        Fat transport in lipoproteins—an integrated approach to mechanisms and disorders.
        New Engl. J. Med. 1967; 275: 34
        • Svanborg A.
        • Vikrot O.
        Plasma lipid fractions, including individual phospholipids, at various stages of pregnancy.
        Acta Med. Scand. 1965; 178: 615
        • Warth M.A.
        • Arky R.A.
        • Knopp R.H.
        Lipid metabolism in pregnancy. II. Altered composition in intermediate, very low, low and high-density lipoprotein fractions.
        J. Clin. Endocrinol. Metab. 1975; 41: 649
        • Schonfeld G.
        • Pfleger B.
        The structure of human high density lipoprotein and the levels of apolipoprotein A-I in plasma as determined by radioimmunoassay.
        J. Clin Invest. 1974; 54: 236
        • Fairweather D.V.
        Changes in serum non-esterified fatty acid levels in spontaneous and in oxytocin induced labour.
        Br. J. Obstet Gynaecol. 1965; 72: 408
        • Potter J.M.
        • Nestel P.J.
        The effects of dietary fatty acids and cholesterol on the milk lipids of lactating women and the plasma cholesterol of breast-fed infants.
        Am. J. Clin. Nutr. 1976; 29: 54
        • Moses C.
        • Rhodes G.L.
        • Leatham E.
        • George R.S.
        Effect of cholesterol feeding during pregnancy on blood cholesterol levels and placental vascular lesions.
        Circulation. 1952; 6: 103
        • Hansen A.E.
        • Wiese H.F.
        • Adam D.J.D.
        • Boelsche A.R.
        • Haggard M.E.
        • Davis H.
        • Newsom W.T.
        • Pesut L.
        Influence of diet on blood serum lipids in pregnant women and newborn infants.
        Am. J. Clin. Nutr. 1964; 15: 11
        • Mullick S.
        • Bagga O.P.
        • du Mullick V.
        Serum lipid studies in pregnancy.
        Am. J. Obstet. Gynecol. 1964; 89: 766
        • Green J.G.
        Serum cholesterol changes in pregnancy.
        Am. J. Obstet. Gynecol. 1966; 95: 387
        • Kekki M.
        • Nikkilä E.A.
        Plasma triglyceride turnover during use of oral contraceptives.
        Metabolism. 1971; 20: 878