30. Maternal lipid profile in early pregnancy and the link with blood pressure and pregnancy complications

Introduction An atherogenic lipid profile is a risk factor for atherosclerosis and consequently for stroke and cardiovascular disease (CVD). An atherogenic lipid profile can cause endothelial dysfunction and consequently higher blood pressure (BP). Placentas of women with a gestational hypertensive disorder (GHD) are histologically comparable to an early stage of atherosclerosis. Objective To determine the association between maternal lipid profile in early pregnancy, GHD and BP throughout pregnancy and six and nine years after pregnancy. Methods We included 5692 women from The Generation R Study; an ongoing population-based prospective birth cohort. 218 (4.1%) women developed gestational hypertension (GH) and 139 (2.6%) women developed pre-eclampsia (PE). Maternal lipid levels included total-cholesterol, triglycerides and HDL-c, and were measured in early pregnancy (median 13.4 weeks of gestation). LDL-c, remnant cholesterol and non-HDL-c were calculated. Systolic and diastolic BP were measured in early, mid- and late pregnancy, and six and nine years after pregnancy. Results In the total population, total-cholesterol, triglycerides, LDL-c, remnant cholesterol and non-HDL-c were positively associated with BP in early, mid- and late pregnancy, six and nine years after pregnancy. Women with PE had higher levels of triglycerides and remnant cholesterol in early pregnancy compared to those with a normotensive pregnancy. Maternal lipid levels in early pregnancy were not associated with GH. Discussion An atherogenic lipid profile in pregnancy is positively associated with BP throughout pregnancy, and six and nine years after pregnancy. In particular triglycerides are important for the risk for PE. Lipid levels in early pregnancy might help to identify women at risk for not only PE, but also future hypertension and consequently initiate early prevention of future CVD.