Lipid Profile in Normal Pregnancy and in Pregnancy Induced Hypertension
Mweu, Shadrack Muindu
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Hypertensive disease in pregnancy (HDP) is a major cause of morbidity for both mother and fetus. Currently HDP is diagnosed by elevated blood pressure (BP) 2:1-.10/90 mmHg and end organ damage including proteinuria both of which can occur due to preexisting conditions. The potential to lower lipids could help to reduce the maternal mortality and complications associated with HDP. The objective of the study was to determine and SQ!1lP.lll"..e the changes in li id profile in ~e~_and nQIDJalpregnancies during the third trimester of pre~cy. The effects of parity and maternal age on the lipid profiles of cases of HDP were also evaluated. This was a matched case control study comprising of 85 cases with an equal number of controls matched on maternal age, gestational age and parity of the cases. Fasting blood samples were collected from the participants by venipuncture and allowed to clot to obtain serum which was analysed for TC, TG and HDL-C using enzymatic and spectrophotometric methods in an auto analyzer. The serum LDL-C level was calculated using the Friedewald's formula. Three of the four parameters TC, TG and LDL-C were statistically significantly different between hypertensive cases and normotensive controls (p<0.05). In contrast there was no statistically significant difference for HDL-C between the hypertensive and control groups (p = 0.11). The mean value of the ratio of TC to HDL-C in the cases was 4.52 ± 2.21 while the mean value for controls was 3.59 ± 0.68 showing statistically significant value, t = 4.07, P = 0.0001. The mean serum levels of TC, TG, HDL-C and LDL-C were not statistically significant when one-way ANOV A and post-ANOV A was performed on cases of varying categories of HDP. Pearson correlation analysis results showed that parity and maternal age do not influence the lipid profiles of cases of hypertensive disease in pregnancy. This study observed that the serum levels of TC, TG and LDL-C are elevated in hypertensive pregnant women relative to normotensive pregnant women. This study recommends that fasting lipid profile test should be considered as a screening test for HDP in addition to the testing for proteins in urine. The management of HDP should not only focus on lowering blood pressure but also in lowering the circulating levels ofTC, TG and LDL-C.