Is maternal lipid profile in early pregnancy associated with pregnancy complications and blood pressure in pregnancy and long-term postpartum?

Abstract Background An atherogenic lipid profile is a risk factor for the initiation and progression of atherosclerosis. This ultimately leads to cardiovascular disease. Women with a history of hypertensive disorders of pregnancy are at increased risk of sustained hypertension and cardiovascular disease later in life. Currently it is unclear if dyslipidemia during pregnancy contributes to these risks. Objective To determine the associations between early pregnancy maternal lipid profile, hypertensive disorders of pregnancy and blood pressure during and years after pregnancy. Study Design We included 5690 women from the Generation R Study; an ongoing population-based prospective birth cohort. 218 (3.8%) women developed gestational hypertension and 139 (2.4%) preeclampsia. A maternal lipid profile consisting of total-cholesterol, triglycerides, HDL-c, LDL-c, remnant cholesterol and non-HDL-c was determined in early pregnancy (median 13.4 weeks of gestation). Systolic and diastolic blood pressure were measured in early, mid- and late pregnancy, and six and nine years after pregnancy. Results Triglycerides and remnant cholesterol in early pregnancy were positively associated with preeclampsia. Maternal lipid levels in early pregnancy were not associated with gestational hypertension. Total-cholesterol, LDL-c, non-HDL-c, and especially triglycerides and remnant cholesterol, were positively associated with blood pressure in pregnancy, and six and nine years after pregnancy. Triglycerides and remnant cholesterol are positively associated with sustained hypertension six years and nine years after pregnancy. Conclusion An atherogenic lipid profile in early pregnancy reflecting impaired triglyceride-rich lipoprotein metabolism is independently associated with preeclampsia and blood pressure throughout pregnancy, but also with sustained hypertension long-term postpartum. Lipid levels in early pregnancy may help to identify women at risk for future hypertension and perhaps also women at risk for future cardiovascular disease.