Maternal and neonatal outcomes in women with disorders of lipid metabolism

J Perinat Med. 2021 Jul 1;49(9):1129-1134. doi: 10.1515/jpm-2021-0028. Print 2021 Nov 25.

Abstract

Objectives: The effects of lipid metabolism disorders (LMD) on pregnancy outcomes is not well known. The purpose of this study is to evaluate the impact of LMD on maternal and fetal outcomes.

Methods: Using the Healthcare Cost and Utilization Project - National Inpatient Sample from the United States, we carried out a retrospective cohort study of all births between 1999 and 2015 to determine the risks of complications in pregnant women known to have LMDs. All pregnant patients diagnosed with LMDs between 1999 and 2015 were identified using the International Classification of Disease-9 coding, which included all patients with pure hypercholesterolemia, pure hyperglyceridemia, mixed hyperlipidemia, hyperchylomicronemia, and other lipid metabolism disorders. Adjusted effects of LMDs on maternal and newborn outcomes were estimated using unconditional logistic regression analysis.

Results: A total of 13,792,544 births were included, 9,666 of which had an underlying diagnosis of LMDs for an overall prevalence of 7.0 per 10,000 births. Women with LMDs were more likely to have pregnancies complicated by diabetes, hypertension, and premature births, and to experience myocardial infarctions, venous thromboembolisms, postpartum hemorrhage, and maternal death. Their infants were at increased risk of congenital anomalies, fetal growth restriction, and fetal demise.

Conclusions: Women with LMDs are at significantly higher risk of adverse maternal and newborn outcomes. Prenatal counselling should take into consideration these risks and antenatal care in specialized centres should be considered.

Keywords: dyslipidemia; fetal outcomes; hypertriglyceridemia; lipid metabolism disorders; lipids; maternal outcomes; pregnancy complications.

MeSH terms

  • Adult
  • Cohort Studies
  • Congenital Abnormalities* / diagnosis
  • Congenital Abnormalities* / epidemiology
  • Directive Counseling / methods
  • Female
  • Fetal Death
  • Fetal Growth Retardation* / diagnosis
  • Fetal Growth Retardation* / epidemiology
  • Humans
  • Infant, Newborn
  • International Classification of Diseases
  • Lipid Metabolism Disorders* / classification
  • Lipid Metabolism Disorders* / complications
  • Lipid Metabolism Disorders* / diagnosis
  • Lipid Metabolism Disorders* / epidemiology
  • Maternal Mortality
  • Pregnancy
  • Pregnancy Complications* / diagnosis
  • Pregnancy Complications* / epidemiology
  • Pregnancy Complications* / metabolism
  • Pregnancy Outcome / epidemiology
  • Prenatal Care* / methods
  • Prenatal Care* / statistics & numerical data
  • Risk Adjustment / methods*
  • Risk Assessment
  • United States / epidemiology