Dyslipidemia in early second trimester is mainly a feature of women with early onset pre-eclampsia.
OBJECTIVE
To investigate whether hypertriglyceridemic dyslipidemia is a risk factor for either early or late onset pre-eclampsia.


METHODS
Prospective cohort study and nested case-control study.


METHODS
Aker Hospital: a university hospital with all levels of obstetric care.


METHODS
2,157 Caucasian pregnant women.


METHODS
Blood samples were obtained from non-fasting subjects at 18 weeks of gestation. All samples were analysed for triglycerides, total-cholesterol, high density lipoproteins cholesterol and non-high density lipoproteins cholesterol. ApoB-100 were analysed in pre-eclamptic women and in 3:1 matched controls. The cohort data were analysed by multiple logistic regression and the case-control data by conditional logistic regression.


METHODS
Adjusted odds ratios of early and late onset pre-eclampsia according to early second trimester serum concentration levels of lipids and ApoB-100.


RESULTS
Eighteen women developed early onset pre-eclampsia and 53 women developed late onset pre-eclampsia. In the cohort model, women with triglycerides above 2.4mmol/L had increased risk (OR 5. 1; 95% CI 1.1-23.1) of early onset pre-eclampsia compared with those with triglycerides levels < or = 1.5mmol/L. For women with high triglycerides: non-high density lipoproteins cholesterol ratios (>90 centile) the OR (95% CI) for early onset pre-eclampsia was 7.1 (2.3-22.0) compared with those with low ratios (< or = 50 centile). Similar associations were found in the case control model. We found no associations between plasma lipids and risk of late onset pre-eclampsia.


CONCLUSIONS
Hypertriglyceridemic dyslipidemia before 20 weeks of gestation is associated with the risk of developing early but not late onset pre-eclampsia, giving support to the contention that these two variants of the disease are at least partly pathogenically different.
Clausen
T
T
Department of Obstetrics and Gynaecology, Aker and Ullevaal University Hospitals, Oslo, Norway.
Djurovic
S
S
Henriksen
T
T
D000328:Adult; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood / Q000150:complications*; D015228:Hypertriglyceridemia / Q000150:complications; D016017:Odds Ratio; D011225:Pre-Eclampsia / Q000097:blood / Q000209:etiology*; D011247:Pregnancy; D011262:Pregnancy Trimester, Second / Q000097:blood; D011446:Prospective Studies