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274: Maternal serum dyslipidemia occurs early in pregnancy in women with mild but not severe preeclampsia

      Objective

      Pregnancy is an atherogenic state, and these changes occur early in pregnancy. Coupled with preeclampsia, this increases the risk for atherosclerosis later in life. Our goal was to compare maternal serum lipids in the second trimester among normal, mild, and severely preeclamptic women.

      Study Design

      A case control study of 50 preeclamptic women (mild=26; severe=24) and 101 normotensive women with uncomplicated term deliveries was conducted. Demographic and medical data were chart abstracted. Preeclamptic women were categorized as mild or severe by ACOG criteria. Banked maternal serum collected for quad screening was accessed to measure lipid profiles. Mean lipid levels were compared between groups using student′s t-test.

      Results

      Women with preeclampsia were similar in age and parity, equally likely to be Caucasian, and were heavier in weight than controls. Women with mild preeclampsia had significantly higher triglycerides and a higher total cholesterol to HDL ratio than controls (199.9 vs. 164.1 mg/dL, p=0.02 and 3.31 vs. 2.91, p=0.02, respectively). Women with severe preeclampsia had significantly lower LDL and non-LDL cholesterol than controls (85.5 vs. 101.5 mg/dL, p=0.04 and 116.0 vs. 134.3 mg/dL, p=0.03, respectively). Women with severe preeclampsia had 13%, 27%, and 22% lower concentrations of total cholesterol, triglycerides, and non-LDL cholesterol than mild preeclamptics (p<0.05). The ratio of total cholesterol to HDL was also 21% lower in the severe preeclamptics (p=0.02).

      Conclusion

      Second trimester maternal dyslipidemia is a risk factor for developing mild but not severe preeclampsia. Women with severe preeclampsia have a less atherogenic lipid profile in the second trimester than both normotensive and mildly preeclamptic women. These findings may be significant in elucidating the different pathologic processes between mild and severe preeclampsia as well as risk for atherosclerosis later in life.