Early Dylipidaemia in Preganacy and the Risk of Pre-Eclampsia: A Longitudinal Study of African Gravid Women

Abstract

Background: Preeclampsia and eclampsia, are the frequent and global obstetrics and gynaecology emergencies in the care of gravid women particularly in African women. Research efforts to identify predictors for recognizing pregnancy that will come down with preeclampsia is still a continuum, yet no single or combination of indices have absolute predictive potential for diagnosing preeclampsia. OBJECTIVE: To evaluate the predictive potentials of sequential alterations of plasma lipids and to determine the gestation age at which dyslipidemia became pathologic to suspect the onset of preeclampsia in gravid African women. Study design: This is a longitudinal study conducted in two phases at the antenatal clinics of a Tertiary hospital. The first Phase was semi-longitudinal and cross-sectional which involved 79 pre-eclamptic and 80 normotensive pregnancy respectively recruited at 3 trimester but followed up to 3days post-partum. The second phase was a full longitudinal study comprising 10 preeclamptic and 20 normotensive healthy pregnant women recruited from the first trimester of pregnancy but were observed up to six weeks post-delivery. Methods: Plasma samples from K2 + EDTA anti-coagulated blood obtained from the preeclamptic and normotensive gravid women at each trimester and postpartum were assayed for lipid profile. which included Triglyceride, Total–Cholesterol, HDLCholesterol by an enzymatic method. VLDL-Cholesterol and LDL-Cholesterol values were calculated. Result: We recorded a sequential and steady increase in all the lipid fractions in both study and controls subjects with the progression in gestation age. Dyslipidaemia was significant (p<0.001) in the preeclamptics at 10.9 week of gestation relative to the controls. Triglyceride alterations became significant (p<0.001) and pathologic to speculate the development of preeclampsia at 10.9 week of gestation (ODS=29.952, CI=1.046-857.998@P<0.04. The lipids regressed significantly to almost pre-pregnancy values at 6 weeks postpartum. Ganiyu O. Adeosun, Department of Medical Laboratory Science, University of Medical Sciences, Ondo City, Ondo State.,Nigeria Mabel A. Charles Davies, Department of Chemical Pathology & Immunology, University College Hospital Ibadan, Nigeria. Omobola A. Ogundahunsi, .Department of Chemical Pathology & Immunology, Olabisi Onabanjo University Ago-Iwoye, Nigeria Jaye Ogunlewe, Department of Chemical Pathology & Immunology, Olabisi Onabanjo University Ago-Iwoye, Nigeria Ibrahim S. Bello, .Department of Family Medicine Obafemi Awolowo University Teaching Hospital Ile-Ife, Nigeria, Tonia Chidinma Onyeneke , Department of Medical Laboratory Science, Andrews University, Michigan, MI 49104, USA Corresponding Author: Ganiyu Oyebola. Adeosun, Department of Medical Laboratory Science, University of Medical Sciences, Ondo City, Ondo State. Conclusion: Physiologic alterations of plasma lipids in early pregnancy can become pathologic to precipitate preeclampsia. Dyslipidaemia and alteration of cardiac risk ratio does not put gravid women at the risk of atherosclerosis.