Serum lipids in early pregnancy and risk of pre-eclampsia

Objective To determine whether first and late second trimester serum total and high density lipoprotein cholesterol are associated with blood pressure, uterine artery pulsatility index and pregnancy outcome. Design A prospective cohort study. Data were analysed using multiple linear and logistic regression analysis. Participants Three hundred and ninety-three pregnant women requesting chorionic villus sampling because of advanced maternal age (36 years and older). Main outcome measures Serum total cholesterol and high density lipoprotein cholesterol were measured by an automated enzymatic method. Uterine artery flow velocity waveforms were recorded using continuous Doppler ultrasound. Pregnancy outcome was assessed by questionnaire. Results First trimester serum total cholesterol was significantly associated with the risk of pre-eclampsia, with the adjusted relative risk exceeding 5 for women with serum total cholesterol levels above 6.0 mmol/l when compared with women with a cholesterol level below 5.0 mmol/l. First trimester serum total cholesterol also showed a significant relationship with diastolic blood pressure (coefficient of linear regression = 0.02 (mmol/l)/mmHg, 95% CI = 0.01 to 0.03), and the change in both diastolic and systolic blood pressure from the first to the late second trimester was associated with linear changes in serum total cholesterol and high density lipoprotein cholesterol. Conclusions These data suggest a relation between serum lipids in early pregnancy and the development of pre-eclampsia.