IMPACT OF LIPID PROFILE ON THE SEVERITY OF PREECLAMPSIA AND MATERNAL MORBIDITY: A CASE CONTROL STUDY
Journal of Evidence Based Medicine and Healthcare
Preeclampsia is a pregnancy-specific disease associated with significant maternal and perinatal mortality and morbidity. Abnormalities in lipid profile have been reported as a feature of the disease. Our aim was to detect the serum lipid profile abnormalities in primigravid women with preeclampsia and its impact on severity of the disease and maternal morbidity. MATERIALS AND METHODS A prospective case-control study was conducted with pregnant subjects presenting to the Obstetric Unit of
... tric Unit of Government Medical College, Thrissur during the period of 1st June 2013 to 31 st May 2014. Study group included 100 primigravidae with preeclampsia between 18 and 40 years of age with singleton pregnancy with gestational age between 24 weeks to term. Control group consisted of 100 matched normotensive pregnant primigravidae. Multipara, multiple gestations, pre-existing hypertension, ischaemic heart disease, chronic renal failure, diabetes mellitus, women taking any drugs which may influence lipid profile were excluded. Assessment of fasting serum lipid profile (12 hrs. fasting) levels of both study and control group was done using fully automated random clinical biochemistry analysers-Erba Manheim XL-640. Women with preeclampsia were grouped into mild and severe preeclampsia. Comparison of fasting serum lipid profile between those with mild and severe preeclampsia was made. Serum fasting serum lipid profile was analysed in women with complications like abruption, HELLP and eclampsia. Their demographic and clinical characteristics were used to generate a database for analysis. STATISTICAL ANALYSIS Data was analysed using Epi info version 7. The data is presented descriptively, providing the number of women, mean with standard deviation. The differences between study group and controls were analysed using t-test for continuous variables. A p value of <0.05 was considered significant. RESULTS The age of the study group was 23.52±3.29 years and of the controls 23.21±3.78 years. Serum Cholesterol (224.99±47.68 mg), Triglycerides (232.33±63.39 mg), LDL-C (123.30±38.45 mg), VLDL-C 46.47±12.68 mg) were significantly increased (p<0.001) in women with preeclampsia compared to normotensives. There was no statistically significant difference in serum HDL-C levels between the two groups. Among women with preeclampsia, 46% had mild disease and 54% had severe disease. In women with severe preeclampsia, serum cholesterol (245.65±45.88 mg), Triglycerides (262.78±54.96 mg), LDL-C (140.85±39.42 mg), VLDL-C (52.56±10.99 mg) were significantly increased (p<0.001) and HDL-C (52.24±6.69 mg) was significantly decreased (p-0.011). Nine women had complications and in those with maternal complications Serum Cholesterol (272.22±38.41 mg), Triglycerides (275.11±34.12 mg), LDL-C (168.09±30.24 mg), VLDL-C (55.02±6.82 mg) were significantly increased (p<0.05) and HDL-C (49.11±4.106 mg) was significantly decreased (p-0.002). CONCLUSIONS Serum lipid profile may be used as an indicator to detect the development of preeclampsia and for prognostication regarding the severity and maternal outcome; dyslipidaemia being a significant risk factor for coronary artery disease, this may help to institute life style modifications and pharmacological interventions to reduce mortality and morbidity in later life.