Publication:

Fetomaternal outcomes of hyperlipidemia in pregnancy

Background Maternal lipid levels increase physiologically during pregnancy; however, excessive elevations may be associated with adverse maternal and neonatal outcomes. This study aimed to evaluate maternal lipid profile patterns and their association with fetomaternal outcomes.

Methods This prospective observational study was conducted on 100 singleton pregnant women with gestational age >28 weeks attending the antenatal clinic and labour room of Pt. B.D. Sharma PGIMS, Rohtak. Detailed history, clinical examination, and body mass index (BMI) assessment were performed. Lipid profiles were analyzed using auto-analyzers. Hyperlipidemia was defined as total cholesterol >200 mg/dL, triglycerides (TGs) ≥150 mg/dL, high-density lipoprotein (HDL-C)≤45 mg/dL, or low-density lipoprotein (LDL)≥130 mg/dL. Participants were followed until delivery and maternal and neonatal outcomes were recorded.

Results Hyperlipidemia was observed in 98% of the study participants. Elevated TGs were seen in 86% and elevated LDL in 37%. Hypercholesterolemia was significantly associated with induction of labour (35.71%, p=0.024). Pre-eclampsia occurred in 22.45% cases, PROM in 21.43%, intrahepatic cholestasis of pregnancy (IHCP) in 8.16%, fetal growth restriction in 3.06% and gestational diabetes mellitus (GDM) in 1.02%. Low HDL levels were significantly associated with maternal anaemia (p=0.012) and elevated LDL levels with IHCP (p=0.049). Low birth weight was observed in 35% neonates and 26.53% required NICU admission, most commonly due to prematurity.

Conclusions Maternal hyperlipidemia was associated with increased maternal complications such as pre-eclampsia, IHCP, and anaemia, as well as neonatal prematurity and NICU admissions. Monitoring lipid profiles during pregnancy may help identify women at risk of adverse fetomaternal outcomes.