Comparative Study of Lipid Profile in Normotensive and Hypertensive Pregnant Women

Introduction: Hypertension (HTN) during pregnancy is one of the leading causes of maternal and perinatal morbidity and mortality. Dyslipidemia is critical in the pathogenesis of endothelial dysfunction. There are a very few studies in this regard from South India. This study compared lipid levels in the hypertensive and normotensive pregnant women and correlated them with the maternal outcome. Methods: This was a prospective, comparative study done at JSS hospital, a tertiary care teaching hospital in Mysore city between December 2012 and April 2014. About 70 patients with HTN in pregnancy, and 70 age-matched normotensive pregnant controls were taken up and lipid levels were analyzed statistically. Results: The majority of the pregnant patients were in the age group of 21-25 years (47.1%) with a mean age of 22 years. The primigravida were 76 (54.3%), the second and third gravida 49 (35%) and 14 (10%), respectively. The mean values of total cholesterol in normotensives was 172 (Standard deviation [SD] +/- 40.8) mg/dl and in hypertensive 279.5 (SD +/- 73.2) P < 0.0001. Mean high density lipoprotein-cholesterol in the hypertensives was 43.3 mg/dl (SD +/- 15.4) and in normotensives 53 mg/dl (SD +/- 11.3) P < 0.0001. Low-density lipoprotein-cholesterol (LDL-C) was significantly increased in hypertensives - mean 162.4 mg/dl (42.8) and 88.4 (SD +/- 30.3) mg/dl in normotensives P < 0.0001. Very LDL-C was significantly increased in hypertensives with mean 68.3 mg/dl (SD +/- 27.9) mg/dl while in normotensives it was 28.7 mg/dl (SD +/- 11.3). Hypertensive patients had a mean triglycerides (TG) of 290.7 mg/dl (SD +/- 126.5) while in normotensive mean TGs was 152.8 mg/dl (SD +/- 48.4) P > 0001. 25 (35.7%) in the hypertensive group had full term normal delivery compared to 46(65.7%) normotensive patients P = 0.001. 45 (64.3%) in the hypertensive group had caesarean section compared to 24 (34.3%) in the normotensive group P = 0.001. Conclusions: The lipid profile parameters were significantly abnormal in hypertensive pregnant patients. Significantly, the more hypertensive pregnancies with dyslipidemia underwent caesarean section Serum lipid levels should be monitored in pregnancy to prevent obstetric complications.