Lipid and lipoprotein concentrations in pregnancies complicated by intrauterine growth restriction

Previous studies have shown that in preeclampsia, plasma lipids climb subst antially above levels seen in normal pregnancies. Such Lipid changes may pl ay a role in the endothelial damage characteristic of preeclampsia. Pregnan cies complicated by intrauterine growth restriction (IUGR), without preecla mpsia, have similar placental pathology to preeclampsia despite the absence of the maternal systemic manifestations of hypertension and proteinuria. T he aim of this study was to perform a cross-sectional study of lipid and li poprotein concentrations in the third trimester, from normal pregnancies, a nd those complicated by IUGR without preeclampsia. Our hypothesis was that, in contrast to the exaggerated Lipid changes seen in preeclampsia, lipid a nd Lipoprotein concentrations in IUGR would be similar to those of matched healthy pregnant controls. Fasting blood samples for Lipids and Lipoprotein fractions were taken in the third trimester, from eight women with IUGR; a nd eight women with uncomplicated pregnancies, matched as a group for age, booking weight, parity, and gestational age at sampling. There were no sign ificant differences (P > 0.05) in the median concentrations of triglyceride , high-density Lipoprotein, and very-low-density Lipoprotein 1 (VLDL1), bet ween cases and controls. However, women with IUGR pregnancies had significa ntly lower cholesterol [4.95 mmol/L (3.35-7.10) vs. 1.47 (5.75-8.45); media n (range) for IUGR patients and controls, respectively; P < 0.01], low-dens ity lipoprotein (LDL)-cholesterol [2.45 mmol/L (0.95-3.60) vs. 4.25 (3.35-5 .60); P < 0.011, VLDL2 mass [59.0 mg/dL (37-87) vs. 103.0 (64-168); P < 0.0 1], intermediate-density Lipoprotein mass [56.0 mg/dL (31-110) vs. 125.6 (9 1-157); P < 0.01], and total LDL mass [221.0 mg/dL (104-237) us. 380.3 (267 -534); P < 0.01]. In addition, it was noteworthy that, with respect to LDL- cholesterol and total LDL mass, there was little or no overlap in the range s of concentrations measured between cases and controls. Because VLDL, and intermediate-density lipoprotein are the synthetic precursors to LDL in the circulation, their significantly lower median concentrations imply a failu re of appropriate LDL synthesis in IUGR pregnancies. Whatever the mechanism , if our results are confirmed in larger studies and longitudinal investiga tions, then LDL-cholesterol measurements (when LDL-cholesterol fails to ris e appropriately or is low in the third trimester) may be of use in identify ing mothers with, or at risk of, a pregnancy complicated by IUGR.