Trends in lipid values among obese women in pregnancy

Abstract

To describe trends in lipids among obese patients in pregnancy and postpartum. This secondary analysis of the PAWS study, a randomized clinical trial of a sleep intervention vs. usual obstetric care in participants with BMI of ≥ 25kg/m 2 was conducted May 2014-April 2015 (NCT01968330). Exclusion criteria included multiple gestations, pregestational diabetes, obstructive sleep apnea, or sleep medication use. Longitudinal data was collected at three-time points: second trimester (T1), third trimester (T2), and 6–8-weeks postpartum (T3). Primary outcome was trend of lipid markers during pregnancy and postpartum. Patients were categorized as dyslipidemic based on the following parameters: TG ≥ 150mg/dL, TC ≥ 200mg/dL, HDL-c < 40mg/dL, LDL-c ≥ 130mg/dL, cholesterol ratio (TC/HDL-c) ≥3.5, TC-HD-c ≥130mg/dL. Non-parametric analyses included Binomial Test within one time point and McNemar Change Test when comparing between time points as appropriate with P value set to < 0.05 as significant. Statistical analyses were performed using IBM SPSS Version 27. We included 42 participants. Baseline characteristics are presented in Table 1. A generalized trend towards dyslipidemia was noted in all values with progression in gestation and postpartum, except for TG. TG significantly decreased from T1 to T3 and T2 to T3 (p 0.039 and 0.040, respectively). Total cholesterol increased from T1 to T2, but significantly decreased from T1 to T3 (p 0.039). Cholesterol ratio significantly increased from T1 to T3 (p < 0.05). HDL-c significantly decreased from T1 to T3 (p 0.031, Table 2). The current analysis demonstrated a statistically significant increase in overall dyslipidemia for most lipid parameters in pregnancy and postpartum consistent with atherogenic phenotype of pregnancy. Triglyceride levels demonstrated an inverse relationship to other atherogenic parameters. The role of maternal triglycerides in context of maternal obesity and its association with pregnancy complications and future CVD risk warrant further study.View Large Image Figure ViewerDownload Hi-res image Download (PPT)