Maternal lipid profile and risk of pre-eclampsia in African pregnant women: A systematic review and meta-analysis.

Endalamaw Tesfa,Endalkachew Nibret,Abaineh Munshea,Frank T Spradley

doi:10.1371/journal.pone.0243538

Endalamaw Tesfa, Endalkachew Nibret + Show 2 more

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https://doi.org/10.1371/journal.pone.0243538

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Journal: PloS one	Publication Date: Dec 23, 2020
Citations: 14	License type: CC BY 4.0

Affiliation: Bahir Dar University

Abstract

IntroductionSome studies have reported the association between maternal serum lipid profile abnormalities and pre-eclampsia. However, many studies have reported controversial results. Hence, this systematic review and meta-analysis was planned to generate summarized evidence on the association between maternal serum lipid profiles and pre-eclampsia in African women.MethodsFour electronic databases such as; PubMed, Hinari, Google Scholar, and African Journals Online were searched for studies published in English. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument and Newcastle-Ottawa Scale were used for data extraction and quality assessment of the included studies. The meta- regression analysis was performed by Stata 14 software. The standardized mean difference (SMD) values of lipid profiles were computed to assess their association with pre-eclampsia at 95% CI.ResultsIn this review a total of 15 observational studies were included. The mean values of triglyceride (TG), total cholesterol (TC), low density lipoprotein- cholesterol (LDL-c) and very low density lipoprotein- cholesterol (VLDL-c) were significantly higher in pre-eclamptic women as compared with normotensive pregnant women (TG = 229.61±88.27 and 147.00 ± 40.47, TC = 221.46 ± 45.90 and 189.67 ± 39.18, LDL = 133.92 ± 38.77 and 112.41 ± 36.08, VLDL = 41.44 ± 19.68 and 26.64 ± 7.87), respectively. The serum high density lipoprotein cholesterol (HDL-c) level was lower, but it is not statistically significant (HDL-c = 51.02 ± 16.01 and 61.80 ± 25.63) in pre-eclamptic women as compared with controls. The pooled standardized mean difference (SMD) of TG, TC, LDL-C and VLDL-C were significantly increased in pre-eclamptic women as compared with normotensive pregnant women with the SMD of (TG = 1.65 (1.10, 2.21), TC = 0.84 (0.40, 1.29), LDL-C = 0.95 (0.46, 1.45) and VLDL-C = 1.27 (0.72, 1.81)) at 95% CI, respectively, but the pooled SMD of HDL-cholesterol was decreased in pre-eclamptic women as compared with normotensive pregnant women (SMD = -0.91 (95% CI: -1.43, -0.39).ConclusionsIn this review, the maternal serum levels of TG, TC, LDL-c and VLDL-c were significantly associated with the risk of preeclampsia. However, HDL- cholesterol was not significantly associated but it was lower in pre-eclamptic women. Further, large scale prospective studies should verify these outcomes and it is recommended that lipid profiles should be included as a routine diagnostic test for pre-eclamptic women.

Highlights

Some studies have reported the association between maternal serum lipid profile abnormalities and pre-eclampsia
The pooled standardized mean difference (SMD) of TG, total cholesterol (TC), low-density lipoprotein (LDL)-C and very low density lipoprotein (VLDL)-C were significantly increased in preeclamptic women as compared with normotensive pregnant women with the SMD of
1.65 (1.10, 2.21), TC = 0.84 (0.40, 1.29), LDL-C = 0.95 (0.46, 1.45) and VLDL-C = 1.27 (0.72, 1.81)) at 95% confidence interval (CI), respectively, but the pooled SMD of high-density lipoprotein (HDL)-cholesterol was decreased in pre-eclamptic women as compared with normotensive pregnant women

Summary

Introduction

Some studies have reported the association between maternal serum lipid profile abnormalities and pre-eclampsia. This systematic review and meta-analysis was planned to generate summarized evidence on the association between maternal serum lipid profiles and pre-eclampsia in African women. Pre-eclampsia is a pregnancy related metabolic syndrome characterized by hypertension and proteinuria occurred after 20 weeks of gestation. It is the most common cause of maternal and prenatal morbidity and mortality [1]. The cause of pre-eclampsia is not clearly known, but failure of spiral artery remodeling cause’s placental ischemia and maternal syndrome resulted in hypertension and proteinuria [2]. The oxidative conversion of LDL- cholesterol to oxidized LDL form is the key event for the initiation and development of atherosclerosis and hypertension [4]

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