Fetal lipoprotein changes in pre‐eclampsia

Objective. To evaluate the impact of maternal lipid changes upon the fetus in pre‐eclampsia (PE) by evaluating lipid profile simultaneously in maternal and umbilical cord blood (UCB). Design. Case‐control study performed on healthy and pre‐eclamptic pregnant women and their neonates. Setting. The Department of Obstetrics and Gynecology, Hospital S. Joao and Faculty of Pharmacy, Porto, Portugal. Samples. Forty‐two healthy pregnancies and 46 pregnancies complicated with PE. Methods. Total cholesterol (TChol), HDL‐cholesterol (HDLc), LDL‐cholesterol (LDLc) and triglycerides (TG) levels were determined using enzymatic methods. Apolipoprotein (apo) A‐I, apoB and lipoprotein (a) [Lp(a)] values were measured by immunoturbidimetry. Main outcome measures. Fetal and maternal plasma levels of TChol, HDLc, LDLc, TG, apoA‐I, apoB and Lp(a). Results. Pre‐eclamptic women presented significantly higher values for TChol, LDLc, HDLc, TG, apoA‐I and apoB compared to normal pregnant women. In the UCB from pre‐eclamptic pregnancies, we observed significantly lower values for HDLc and apoA‐I, and significantly higher TG concentrations and LDLc/HDLc ratio when compared to normal cases. A positive correlation was observed between maternal TG levels and proteinuria, a marker of PE severity (r =0.40, p <0.01). Conclusions. Our data suggest that pre‐eclamptic pregnancy is associated with an enhanced hyperlipidemia, which seems to have a negative impact on fetal lipid profile, as reflected by a higher atherogenic LDLc/HDLc ratio and higher TG levels. These children, born of women with PE, may deserve a closer clinical follow‐up later in life.

[1]  D J Barker,et al.  In utero programming of chronic disease. , 1998, Clinical science.

[2]  E. Gratacós,et al.  Increased susceptibility to low density lipoprotein oxidation in women with a history of pre‐eclampsia , 2003, BJOG : an international journal of obstetrics and gynaecology.

[3]  G. Woelk,et al.  Plasma carotenoids, retinol, tocopherols, and lipoproteins in preeclamptic and normotensive pregnant Zimbabwean women. , 2003, American journal of hypertension.

[4]  B. Carbonne,et al.  High polyunsaturated fatty acid, thromboxane A2, and alpha-fetoprotein concentrations at the human feto-maternal interface. , 1997, Journal of lipid research.

[5]  L. Pereira-leite,et al.  Changes in LDL size and HDL concentration in normal and preeclamptic pregnancies. , 2002, Atherosclerosis.

[6]  I. Cetin,et al.  Placental LPL Gene Expression Is Increased in Severe Intrauterine Growth-Restricted Pregnancies , 2006, Pediatric Research.

[7]  M. Mori,et al.  Levels of lipoprotein(a) in normal and compromised pregnancy , 2003, Journal of perinatal medicine.

[8]  C. Packard,et al.  Lipoprotein (a) levels in normal pregnancy and in pregnancy complicated with pre-eclampsia. , 2000, Atherosclerosis.

[9]  N. Sattar,et al.  Fetal cord plasma lipoprotein status in uncomplicated human pregnancies and in pregnancies complicated by pre-eclampsia and intrauterine growth restriction. , 2004, Atherosclerosis.

[10]  L. Myatt,et al.  Transport of cholesterol across a BeWo cell monolayer: implications for net transport of sterol from maternal to fetal circulation. , 2003, Journal of lipid research.

[11]  D. Sahota,et al.  Impact of hypertensive disorders of pregnancy at term on infant birth weight , 2005, Acta obstetricia et gynecologica Scandinavica.

[12]  R. Frydman,et al.  CONCENTRATIONS OF APOLIPOPROTEINS E, C2 AND C3 AND LIPID PROFILE IN PREECLAMPSIA , 2002, Hypertension in pregnancy.

[13]  H. Kodama,et al.  Decreased very-low-density lipoprotein and low-density lipoprotein receptor messenger ribonucleic acid expression in placentas from preeclamptic pregnancies. , 1996, American journal of obstetrics and gynecology.

[14]  E. Amusquivar,et al.  Lipid metabolism in the fetus and the newborn , 2000, Diabetes/metabolism research and reviews.

[15]  I. Davas,et al.  Lipoprotein(a) levels in women with pre‐eclampsia and in normotensive pregnant women , 2005, The journal of obstetrics and gynaecology research.

[16]  Jean-Marie Moutquin,et al.  The Classification and Diagnosis of the Hypertensive Disorders of Pregnancy: Statement from the International Society for the Study of Hypertension in Pregnancy (ISSHP) , 2001, Hypertension in pregnancy.

[17]  E. Sarandöl,et al.  Lipid and protein oxidation and antioxidant function in women with mild and severe preeclampsia , 2003, Archives of Gynecology and Obstetrics.

[18]  Z. Akkuş,et al.  Potential atherogenic roles of lipids, lipoprotein(a) and lipid peroxidation in preeclampsia. , 2005, Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology.

[19]  P. Haggarty.  Placental regulation of fatty acid delivery and its effect on fetal growth--a review. , 2002, Placenta.

[20]  A. von Eckardstein,et al.  The emergence of triglycerides as a significant independent risk factor in coronary artery disease. , 1998, European heart journal.

[21]  M. Hod,et al.  The elevated plasma lipoprotein(a) concentrations in preeclampsia do not precede the development of the disorder. , 2002, Thrombosis research.

[22]  G. Ciuffetti,et al.  Mechanisms of high-density lipoprotein cholesterol effects on the endothelial function in hyperlipemia. , 2003, Metabolism: clinical and experimental.

[23]  S. Sanchez,et al.  The influence of maternal triglyceride levels on infant birth weight in Peruvian women with pre-eclampsia , 2003, The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians.

[24]  L. Pereira-leite,et al.  LDL size, total antioxidant status and oxidised LDL in normal human pregnancy: a longitudinal study. , 2004, Atherosclerosis.

[25]  W. März,et al.  Triglyceride-rich lipoproteins are associated with hypertension in preeclampsia. , 2003, The Journal of clinical endocrinology and metabolism.

[26]  P. Haggarty.  Effect of placental function on fatty acid requirements during pregnancy , 2004, European Journal of Clinical Nutrition.

[27]  M. Kilby,et al.  Fetal and maternal lipoprotein metabolism in human pregnancy complicated by type I diabetes mellitus. , 1998, The Journal of clinical endocrinology and metabolism.

[28]  E. Onur,et al.  Atherogenic profile in preeclampsia , 2003, Archives of Gynecology and Obstetrics.

[29]  M. Gordon,et al.  Uptake of long chain fatty acids by human placental choriocarcinoma (BeWo) cells: role of plasma membrane fatty acid-binding protein. , 1997, Journal of lipid research.

[30]  Kunihiko Kobayashi,et al.  Unique character and metabolism of high density lipoprotein (HDL) in fetus. , 2002, Atherosclerosis.