Review Article: Pregnancy and CVD Risk Factors

Abstract

Elevated concentrations of total cholesterol, particular lipoproteins (e.g., LDL) and homocysteine are risk factors for cardiovascular disease and vascular dysfunction that can adversely affect the health of a pregnant woman and her fetus. Although it has been documented in many populations worldwide that the serum total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglyceride levels increase substantially by the third trimester, there are few reports of the levels of these risk factors in pregnant women in sub-Saharan Africa. We therefore compared the levels of these lipids and homocysteine in the serum of third-trimester pregnant women (n=18) and healthy, age-matched non-pregnant controls (n=38) in Abuja, Nigeria. Relative to the controls, the following substances were significantly elevated in the pregnant women: total cholesterol, 212 vs. 191 mg/dL (p=0.02); triglycerides, 153 vs. 89.5 mg/dL (p=0.004); and HDL, 67.0 vs. 56.6 mg/dL (p=0.004). The mean LDL-cholesterol levels of the pregnant (116 mg/dL) and non-pregnant controls (110 mg/dL) were not significantly different. However, the mean homocysteine concentration of the pregnant women was about 30% lower compared with the control group (7.1 vs. 10.1 mol/L, p<0.001). The mean folate level of the pregnant women, 16/18 of whom were taking a multivitamin supplement, was more than twice that of the non-pregnant controls (10.4 vs. 4.4 ng/mL, p=0.002), whereas the vitamin B12 level was nearly two-fold higher in the controls than in the pregnant women (620 vs. 343 pg/mL, p=0.001). These results indicate that pregnant women in Nigeria we studied show the same trend that most women in other parts of the world exhibit as they enter the third trimester of pregnancy; that is, their serum cholesterol and triglyceride levels increase, while their homocysteine levels decrease. The lower homocysteine levels in the pregnant women relative to the non-pregnant women were likely due to the use of folate supplements by the pregnant women. Despite the difference in the serum lipid profiles of the pregnant and non-pregnant women, both groups had values of serum concentrations of lipids, folate, vitamin B12 and homocysteine that were well within the reference range of values provided by the American Heart Association (AHA).

Key words: cholesterol, LDL, HDL, lipid ratios, homocysteine, pregnant, and CVD risk factors

Highland Medical Research Journal Vol.2(2) 2004: 1-8