Department of Internal Medicine, Erasmus MC Cardiovascular Institute, University Medical Center Rotterdam, Rotterdam.
Department of Pediatrics.
Curr Opin Lipidol. 2024 Jun 1;35(3):133-140. doi: 10.1097/MOL.0000000000000927. Epub 2024 Feb 21.
Accommodating fetal growth and development, women undergo multiple physiological changes during pregnancy. In recent years, several studies contributed to the accumulating evidence about the impact of gestational hyperlipidemia on cardiovascular risk for mother and child. This review aims to provide a comprehensive overview of the current research on lipid profile alterations during pregnancy and its associated (cardiovascular) outcomes for mother and child from a clinical perspective.
In a normal pregnancy, total and LDL-cholesterol levels increase by approximately 30-50%, HDL-cholesterol by 20-40%, and triglycerides by 50-100%. In some women, for example, with familial hypercholesterolemia (FH), a more atherogenic lipid profile is observed. Dyslipidemia during pregnancy is found to be associated with adverse (cardiovascular) outcomes for the mother (e.g. preeclampsia, gestational diabetes, metabolic syndrome, unfavorable lipid profile) and for the child (e.g. preterm birth, large for gestational age, preatherosclerotic lesions, unfavorable lipid profile).
The lipid profile of women during pregnancy provides a unique window of opportunity into the potential future cardiovascular risk for mother and child. Better knowledge about adverse outcomes and specific risk groups could lead to better risk assessment and earlier cardiovascular prevention. Future research should investigate implementation of gestational screening possibilities.
为了适应胎儿的生长发育，女性在怀孕期间会经历多种生理变化。近年来，一些研究为妊娠性高脂血症对母婴心血管风险的影响提供了越来越多的证据。本篇综述旨在从临床角度全面概述怀孕期间血脂谱变化及其与母婴相关（心血管）结局的研究现状。
在正常妊娠中，总胆固醇和 LDL-胆固醇水平增加约 30-50%，HDL-胆固醇增加 20-40%，甘油三酯增加 50-100%。在某些女性中，例如家族性高胆固醇血症（FH），会观察到更具动脉粥样硬化倾向的血脂谱。研究发现，妊娠期间的血脂异常与母亲的不良（心血管）结局（如先兆子痫、妊娠糖尿病、代谢综合征、血脂谱不良）和儿童的不良结局（如早产、胎儿过大、动脉粥样硬化前病变、血脂谱不良）有关。
女性在怀孕期间的血脂谱为了解母婴未来潜在心血管风险提供了一个独特的窗口。更好地了解不良结局和特定的风险群体，可以帮助进行更好的风险评估和早期心血管预防。未来的研究应调查实施妊娠筛查的可能性。
