High triglycerides during pregnancy linked to preeclampsia, diabetes

Original Article

by Michelle Rizzo

NEW YORK (Reuters Health) - High triglyceride levels during pregnancy are associated with increased risks for preeclampsia and gestational diabetes, a new study shows.

"Pregnancy," study investigator Dr. Victor Novack commented to Reuters Health, "is a "natural 'stress test' for mother. Any morbidity showing up during pregnancy might be an early sign of later disease."

Dr. Novack, of Harvard Clinical Research Institute, Boston, Massachusetts, and colleagues studied lipid changes during gestation and their association with adverse pregnancy outcomes in 9911 healthy women without cardiovascular comorbidities.

The composite endpoint (preeclampsia or gestational diabetes mellitus) occurred in 1209 women (12.2%), they report in the American Journal of Obstetrics and Gynecology for November.

The investigators observed substantial variability in lipid levels during pregnancy, with a nadir following conception and a peak at delivery. "Compared to preconception levels, total cholesterol levels increased by almost 50% and triglyceride levels more than doubled," Dr. Novack told Reuters Health.

The prevalence of preeclampsia or gestational diabetes increased with levels of triglycerides, from 7.2% in the group with low triglycerides (<25th percentile adjusted for the gestational month) to 19.8% in the group with high triglycerides (>75th percentile).

Preeclampsia or gestational diabetes was not associated with high-density lipoprotein levels.

In multivariate analysis, higher triglycerides, but not low high-density lipoprotein, were significantly associated with an increased risk of pregnancy complications.

Commenting on the findings, Dr. Novack said, "We think that it is possible to define a 'metabolic syndrome' of pregnancy. Pregnancy is a natural state of insulin resistance. Women characterized by a higher level of the insulin resistance may develop any of the complications associated with the metabolic syndrome: high triglycerides, high blood pressure, and hyperglycemia. Identifying women at high risk for these complications may help to develop a prevention strategy."