Dyslipidemia in early second trimester is mainly a feature of women with early onset pre-eclampsia

Objective To investigate whether hypertriglyceridemic dyslipidemia is a ris k factor for either early or late onset pre-eclampsia. Design Prospective cohort study and nested case-control study. Setting Aker Hospital: a university hospital with all levels of obstetric c are. Participants 2157 Caucasian pregnant women. Methods Blood samples were obtained from non-fasting subjects at 18 weeks o f gestation. All samples were analysed for triglycerides, total-cholesterol , high density lipoproteins cholesterol and non-high density lipoproteins c holesterol. ApoB-100 were analysed in pre-eclamptic women and in 3:1 matche d controls. The cohort data were analysed by multiple logistic regression a nd the case-control data by conditional logistic regression. Main outcome measures Adjusted odds ratios of early and late onset pre-ecla mpsia according to early second trimester serum concentration levels of lip ids and ApoB-100. Results Eighteen women developed early onset pre-eclampsia and 53 women dev eloped late onset pre-eclampsia. In the cohort model, women with triglyceri des above 2.4 mmol/L had increased risk (OR 5. 1; 95% Cl 1.1-23.1) of early onset pre-eclampsia compared with those with triglycerides levels less tha n or equal to 1.5mmol/L. For women with high triglycerides: non-high densit y lipoproteins cholesterol ratios (> 90 centile) the OR (95% CI) for early onset pre-eclampsia was 7.1 (2.3-22.0) compared with those with low ratios (less than or equal to 50 centile). Similar associations were found in the case control model. We found no associations between plasma lipids and risk of late onset pre-eclampsia. Conclusions Hypertriglyceridemic dyslipidemia before 20 weeks of gestation is associated with the risk of developing early but not late onset pre-ecla mpsia, giving support to the contention that these two variants of the dise ase are at least partly pathogenically different.