A study of serum lipid profile in normal pregnancy and pregnancy induced hypertensive disorders: a case-control study

摘要

Background: Pregnancy induced hypertensive disorders are one of the commonest complication of pregnancy which accounts for 12% of the maternal and perinatal mortality and morbidity. Dyslipidemias are associated with endothelial dysfunction that may result in proteinuria and hypertension which is a clinical hallmark of PIH. It affects both maternal health as well as fetal growth. Hence, this study was done to assess the role of altered lipid profile in the development of PIH. Methods: A Case Control study was conducted at the Department of Biochemistry, Kurnool Medical College and Govt General Hospital, Kurnool in collaboration with its Obstetrics Dept during the period of November 2015-2017. A total of 300 pregnant women, primigravida /multigravida with singleton pregnancy, in the age group of 18‐ 35 years with 20 weeks of gestation were included in the study. Subjects were divided into gestational hypertensives, n=39 (BP ≥140/80) and preeclamptic women, n=111 (≥140/80 and proteinuria) as cases. Age matched normotensive pregnant women, n=150 (BP 120/80) were recruited as Controls. Subjects with history of multiple pregnancies, pregnancy with congenital anomalies, chronic hypertension, diabetes mellitus, cardiac/thyroid/hepatic/renal disease, dyslipidemia were excluded. Total cholesterol, TG, HDL, LDL, VLDL were performed. Results: A comparison of these values between hypertensive and normotensive women showed a significant rise in TC, TG, LDL and VLDL. HDL-C showed a significant decrease in hypertensive women compared to normal pregnant women. LDL: HDL and TG:HDL ratios were higher in PIH group. Conclusions: The results of this study suggests an abnormal lipid metabolism, predominantly high TG concentrations and low HDL-C, which may add to the promotion of vascular dysfunction and oxidative stress seen in PIH. This association is significant in understanding the development of hypertension during pregnancy and is useful in early diagnosis and prevention of PIH.