title: Pre-Conception Dyslipidemia Is Associated with Development of Preeclampsia and Gestational Diabetes Mellitus.
abstract: BACKGROUND
  The association between glucose intolerance, elevated blood pressure and abnormal lipid levels is well established and comprises the basis of metabolic syndrome pathophysiology. We hypothesize that abnormal preconception lipid levels are associated with the increased risk of severe pregnancy complications such as preeclampsia and gestational diabetes mellitus.
  
  
  METHODS
  We included all singleton deliveries (n = 27,721) of women without known cardiovascular morbidity and preeclampsia and gestational diabetes mellitus during previous pregnancies. Association between preconception low high density lipoprotein cholesterol (HDLc level≤50 mg/dL), high triglycerides (level≥150 mg/dL) and the primary outcome (composite of gestational diabetes mellitus/or preeclampsia) was assessed using Generalized Estimation Equations.
  
  
  RESULTS
  Primary outcome of preeclampsia and/or gestational diabetes was observed in a total of 3,243 subjects (11.7%). Elevated triglycerides and low HDLc were independently associated with the primary outcome: with odds ratio (OR) of 1.61 (95% CI 1.29-2.01) and OR = 1.33 (95% CI 1.09-1.63), respectively, after adjusting for maternal age, weight, blood pressure, repeated abortions, fertility treatments and fasting glucose. There was an interaction between the effects of HDLc≤50 mg/dL and triglycerides≥150 mg/dL with an OR of 2.69 (95% CI 1.73-4.19).
  
  
  CONCLUSIONS
  Our analysis showed an increased rate of preeclampsia and/or gestational diabetes in women with low HDLc and high triglycerides values prior to conception. In view of the severity of these pregnancy complications, we believe this finding warrants a routine screening for the abnormal lipid profile among women of a child-bearing age.
authors.affiliation: Soroka Clinical Research Center, Soroka University Medical Center, Be'er-Sheva, Israel; Department of Obstetrics and Gynecology, Soroka University Medical Center, Be'er-Sheva, Israel.
authors.forename: Yael
authors.initials: Y
authors.lastname: Baumfeld
authors.affiliation: Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er-Sheva, Israel.
authors.forename: Lena
authors.initials: L
authors.lastname: Novack
authors.affiliation: Department of Obstetrics and Gynecology, Soroka University Medical Center, Be'er-Sheva, Israel.
authors.forename: Arnon
authors.initials: A
authors.lastname: Wiznitzer
authors.affiliation: Department of Obstetrics and Gynecology, Soroka University Medical Center, Be'er-Sheva, Israel.
authors.forename: Eyal
authors.initials: E
authors.lastname: Sheiner
authors.affiliation: Department of Cardiology, Soroka University Medical Center, Be'er-Sheva, Israel.
authors.forename: Yakov
authors.initials: Y
authors.lastname: Henkin
authors.affiliation: Medical Administration, Clalit Health Services, Tel-Aviv, Israel.
authors.forename: Michael
authors.initials: M
authors.lastname: Sherf
authors.affiliation: Soroka Clinical Research Center, Soroka University Medical Center, Be'er-Sheva, Israel.
authors.forename: Victor
authors.initials: V
authors.lastname: Novack
mesh_terms: D000328:Adult; D008076:Cholesterol, HDL / Q000097:blood; D016640:Diabetes, Gestational / Q000097:blood / Q000209:etiology*; D050171:Dyslipidemias / Q000097:blood / Q000150:complications*; D005260:Female; D006801:Humans; D011225:Pre-Eclampsia / Q000097:blood / Q000209:etiology*; D011247:Pregnancy; D014280:Triglycerides / Q000097:blood; D055815:Young Adult
chemical_list: D008076:Cholesterol, HDL; D014280:Triglycerides