Dyslipemias and pregnancy, an update

Area of Science:

• Obstetrics and Gynecology
• Cardiovascular Medicine
• Metabolic Disorders

Background:

• Physiological increases in total cholesterol (TC) and triglycerides (TG) occur during pregnancy, influenced by hormones like oestrogens and placental lactogen.
• Elevated lipid levels, particularly exceeding the 95th percentile, can lead to oxidative stress in foetal vessels, increasing the risk of atherosclerosis in newborns.
• Current management for hyperlipidaemia in pregnancy relies on diet and drug suspension, with limited specific protocols for severe cases.

Purpose of the Study:

• To highlight the importance of evaluating dyslipidaemia during pregnancy.
• To emphasize the risks associated with maternal hyperlipidaemia for both mother and foetus.
• To advocate for the establishment of consensus protocols for managing dyslipidaemia in pregnancy.

Main Methods:

• Literature review on physiological lipid changes during pregnancy.
• Analysis of risks associated with maternal hypercholesterolaemia and hypertriglyceridaemia.
• Discussion of current treatment limitations and the need for specific guidelines.

Main Results:

• Pregnancy-induced hyperlipidaemia can reach levels of 350mg/dL for TC and 300mg/dL for TG.
• Severe maternal hypertriglyceridaemia (HTG), especially genetic forms, increases risks of acute pancreatitis, pre-eclampsia, preterm labour, and gestational diabetes.
• Lack of specific diagnostic and treatment protocols for severe HTG-AP poses a significant maternal-foetal risk.

Conclusions:

• Dyslipidaemia in pregnancy requires careful evaluation due to acute complications and long-term cardiovascular risks for the child.
• Severe hypertriglyceridaemia during pregnancy is a critical condition with potential lethal outcomes.
• Establishing consensus protocols is essential for the effective management of pregnancy-related dyslipidaemia.