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The current status of lipoprotein (a) in pregnancy: a literature review
Angela E Fanshawe1, Michael Ibrahim
1National Heart and Lung Institute, Imperial College London, UK.
Insights
Lipoprotein (a) levels change during pregnancy, impacting maternal and fetal health. Further research is needed to fully understand these changes and their clinical implications in normal and complicated pregnancies.
Area of Science:
- Reproductive Medicine
- Cardiovascular Science
- Biochemistry
Background:
- Lipoprotein (a) [Lp(a)] is a key blood lipid marker.
- Lp(a) is linked to coronary heart disease, atherosclerosis, and thrombosis.
- Pregnancy significantly alters maternal metabolism.
Purpose of the Study:
- To synthesize and evaluate existing evidence on Lp(a) in pregnancy.
- To assess the role of Lp(a) in normal and complicated pregnancies.
- To identify gaps in current research on Lp(a) and pregnancy.
Main Methods:
- Systematic review of MEDLINE database.
- Literature search from May 2003 to May 2012.
- Analysis of 14 studies on Lp(a) profiles in pregnancy.
Main Results:
- Reviewed studies on normal pregnancy metabolic responses.
- Analyzed pregnancies with pre-eclampsia and intrauterine growth restriction.
- Examined the effect of pregnancy complications on Lp(a) levels and outcomes.
Conclusions:
- Significant data exists on Lp(a) changes during pregnancy.
- Diverse study designs limit broad conclusions.
- Key unanswered questions regarding Lp(a) in pregnancy were identified.
Background And Purpose:
Lipoprotein (Lp) (a) is a neglected element of the blood lipid profile. It is now recognized as a determinant of coronary heart disease progression and its role in atherosclerosis and its ability to induce thrombosis make it potentially important in the course of normal and complicated pregnancies. Pregnancy involves a major transformation of metabolism to sustain fetal growth. Multiple studies have been conducted on Lp(a) in pregnancy, and it is timely to synthesize and evaluate this evidence.
Methods And Subjects:
We reviewed the MEDLINE database for all articles published concerning "lipoprotein a" and "pregnancy" from May 2003 to May 2012. A previous comprehensive review assessed the literature up to May 2003.
Results:
We critically analyzed 14 studies detailing the effect of complications in pregnancy on Lp(a) profile, and subsequent pregnancy outcomes where available. Studies evaluating the normal metabolic response to pregnancy, pregnancies complicated by pre-eclampsia and intra-uterine growth restriction were reviewed.
Conclusions:
A substantial mass of data has accumulated describing Lp(a) changes in pregnancy. The diversity of study design limits the ability to draw broad-ranging conclusions, but brings into focus the important questions remaining, which we discuss.
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