Role of dyslipidemia and lipid peroxidation in pregnancy induced hypertension

Background: Pregnancy induced hypertension (PIH) contributes greatly to maternal morbidity and mortality. Altered lipid profile and increased lipid peroxidation activate endothelial dysfunction and atherothrombosis leading to PIH. Therefore, estimation of lipid profile with serum malondialdehyde (MDA) in pregnancy may be helpful in predicting the development of PIH and further progression. Material and methods: In this prospective case-control study, serum lipid profile and MDA were estimated in 70 PIH subjects with gestational hypertension, pre-eclampsia, eclampsia; and 70 normotensive pregnant women aged 18 - 40 years, with gestational age of over 20 weeks. Results: A statistically significant higher serum total cholesterol, very low density lipoprotein cholesterol (VLDL-C), low density lipoprotein cholesterol (LDL-C), triglycerides (TG), TC/HDL-C, LDL-C/HDL-C and MDA, and a significantly lower HDL-C was noted in PIH subjects as compared to control subjects. When compared with the severity of PIH, all the lipoproteins (except HDL-C) along with MDA were found to be higher in women with eclampsia when compared with gestational hypertension, pre-eclampsia and normotensive pregnant women. Conclusions: An abnormal lipid metabolism along with oxidative stress may add to the promotion of vascular dysfunction leading to PIH. Lipoproteins and MDA alter significantly in eclampsia. Therefore, during pregnancy, early diagnosis and management of dyslipidaemia may prevent lipid peroxidation and progression of PIH thereby preventing obstetric complications.