Fetal lipoprotein changes in pre-eclampsia.

Objective: To evaluate the impact of maternal lipid changes upon the fetus in pre-eclampsia (PE) by evaluating lipid profile simultaneously in maternal and umbilical cord blood (UCB).

Design: Case-control study performed on healthy and pre-eclamptic pregnant women and their neonates.

Setting: The Department of Obstetrics and Gynecology, Hospital S. Joao and Faculty of Pharmacy, Porto, Portugal.

Samples: Forty-two healthy pregnancies and 46 pregnancies complicated with PE. Methods. Total cholesterol (TChol), HDL-cholesterol (HDLc), LDL-cholesterol (LDLc) and triglycerides (TG) levels were determined using enzymatic methods. Apolipoprotein (apo) A-I, apoB and lipoprotein (a) [Lp(a)] values were measured by immunoturbidimetry.

Main Outcome Measures: Fetal and maternal plasma levels of TChol, HDLc, LDLc, TG, apoA-I, apoB and Lp(a).

Results: Pre-eclamptic women presented significantly higher values for TChol, LDLc, HDLc, TG, apoA-I and apoB compared to normal pregnant women. In the UCB from pre-eclamptic pregnancies, we observed significantly lower values for HDLc and apoA-I, and significantly higher TG concentrations and LDLc/HDLc ratio when compared to normal cases. A positive correlation was observed between maternal TG levels and proteinuria, a marker of PE severity (r =0.40, p <0.01).

Conclusions: Our data suggest that pre-eclamptic pregnancy is associated with an enhanced hyperlipidemia, which seems to have a negative impact on fetal lipid profile, as reflected by a higher atherogenic LDLc/HDLc ratio and higher TG levels. These children, born of women with PE, may deserve a closer clinical follow-up later in life.