EFFECT OF PREGNANCY ON THE LIPID PROFILE IN EGYPTIAN WOMEN

Background:Blood lipid concentration increase significantly during pregnancy. The increased progesterone in the 2nd half of pregnancy may act to reset the lipostat in the hypothalamus. There is conflicting evidence for an association between parity and the risk of cardiovascular disease in women. Previous studies have reported a decline in HDL cholesterol up to 10 years after the first pregnancy.Objective: To detect the effect of pregnancy on the lipid profile during normal pregnancy in the different trimesters.Patients andMethods: This study included 100 cases; 80 pregnant women and 20 healthy non-pregnant women matched for age as control. All patients subjected to: Compete history taking and clinical examination, twelve leads resting surface ECG, echocardiography and total Lipid Profile (at the middle of each trimester and 6-12 weeks post-partum) In general, the test performed following 12 hours overnight fast.Results:The total cholesterol and triglycerides were significantly increased from the 1stto the 2ndtrimester with further significant increase in the 3rdtrimesterand after delivery there were highly significant decrease in both. (TC changed from 196+18 mg/dl to 216 +19.3 mg /dl to 243+13.5 mg/dl with P<0.05 then to 187.1+19.3 mg/dl with P<0.001, respectively). The LDL cholesterol, HDL cholesterol and VLDL cholesterol were non-significantly changed from the 1sttrimester to the 2ndtrimester with significant increase in the 3rd trimester and after delivery it was highly significant decreased to the below or near the 1sttrimester level(LDLchanged from 119+ 9 mg/dl to 111.9+11.5 mg /dl to 123.5+11.9 mg/dl with P>0.05 then to 112.6+13.8 mg/dl with P<0.001, respectively) (HDL changed from 41.9+ 14 mg/dl to 42.8+15.4 mg /dl, with P<0.05 then to 57.9+23.1 mg/dl to 48.6+25 mg/dl with P<0.001, respectively) Conclusions:We have demonstrated that normal pregnancy is associated with raised triglycerides and cholesterol. By the third trimester most women have a lipid profile which would be considered highly atherogenic in the non-pregnant state. However this represents a transient disturbance which reverts to normal after delivery. Further studies are needed to determine the risk and cardiovascular effects of disturbed lipid profile during pregnancy especially in multipara women with repeated pregnancy.