Department of Internal Medicine, University of Genoa, 16132 Genoa, Italy.
Dietetics and Clinical Nutrition Unit, IRCCS Policlinic Hospital San Martino, 16132 Genoa, Italy.
Nutrients. 2024 Sep 1;16(17):2927. doi: 10.3390/nu16172927.
Dyslipidemia is a significant risk factor for atherosclerotic cardiovascular disease (ASCVD). During pregnancy, physiological changes elevate cholesterol and triglyceride levels to support fetal development, which can exacerbate pre-existing conditions and lead to complications such as pre-eclampsia, gestational diabetes, and increased ASCVD risk for both mother and child. Effective management strategies are necessary, especially for pregnant women with inherited forms of dyslipidemia (i.e., familial hypertriglyceridemia, hyperchylomicronemia), where personalized dietary adjustments are crucial for successful pregnancy outcomes. Pharmacological interventions and lipoprotein apheresis may be necessary for severe cases, though their use is often limited by factors such as cost, availability, and potential fetal risks. Despite the promise of advanced therapies, their widespread application remains constrained by limited studies and high costs. Thus, a personalized, multidisciplinary approach is essential for optimizing outcomes. This review provides a comprehensive overview of current strategies and evidence-based practices for managing dyslipidemia during pregnancy, emphasizing the balance of maternal and fetal health. Additionally, it discusses the physiological changes in lipid metabolism during pregnancy and their implications, particularly for women with inherited forms of dyslipidemia.
血脂异常是动脉粥样硬化性心血管疾病（ASCVD）的重要危险因素。怀孕期间，生理变化会提高胆固醇和甘油三酯水平，以支持胎儿发育，这可能会使原有疾病恶化，并导致妊娠并发症，如子痫前期、妊娠糖尿病，以及母婴 ASCVD 风险增加。需要采取有效的管理策略，特别是对于患有遗传性血脂异常（即家族性高甘油三酯血症、高乳糜微粒血症）的孕妇，个性化的饮食调整对于成功的妊娠结局至关重要。对于严重病例，可能需要药物干预和脂蛋白吸附，但由于成本、可用性和潜在胎儿风险等因素，其使用往往受到限制。尽管有先进疗法的前景，但由于研究有限且成本高昂，其广泛应用仍受到限制。因此，个性化、多学科的方法对于优化母婴结局至关重要。本综述全面概述了妊娠期间血脂异常的现有管理策略和循证实践，强调了母婴健康的平衡。此外，还讨论了怀孕期间脂代谢的生理变化及其影响，特别是对于患有遗传性血脂异常的女性。
