Effect of eicosapentaenoic acid agent on aggravated hypertriglyceridemia during pregnancy

Aggravated hypertriglyceridemia with a serum triglyceride of more than 1000mg/dL is a risk of acute pancreatitis during pregnancy. However, there have been few reports on the administration of an eicosapentaenoic acid (EPA) agent for aggravated hypertriglyceridemia during pregnancy. A 29-year-old multiparous Japanese woman was transferred to our hospital at 29+0 weeks of gestation due to hypertriglyceridemia of 898mg/dL. Because diet control was not enough, we decided to use an EPA agent, resulting in a reduction in triglyceride levels to 550mg/dL. A male infant, weighing 2667g, was born at 37+2 weeks transabdominally, and was complicated with respiratory distress syndrome. The final diagnosis was type III hyperlipoproteinemia with the apolipoprotein E3/2 phenotype and a broad -migrating lipoprotein on polyacrylamide gel electrophoresis of serum lipoproteins. In conclusion, an EPA agent may be a possible therapeutic approach for aggravated hypertriglyceridemia during pregnancy, although it may increase a risk of respiratory distress syndrome.