Lipid profile in consecutive pregnancies

Aim. To describe the lipid profile of women prior to, during and after pregnancy and to assess the effect of consecutive pregnancies on the plasma lipid profile. Methods. Blood lipid levels of 1752 women aged 20-45 years who delivered between 1999 and 2005 were measured. The lipid profile included total cholesterol, LDL-C (Low density lipoprotein), HDL-C (High density lipoprotein-C), VLDL-C (Very low density lipoprotein) and triglycerides (TG). The measurements were classified into the following categories: non-pregnant state (12 months prior to conception), during the three trimesters of pregnancy and from 6 weeks to 12 months postpartum. This profile was tested in up to three subsequent pregnancies. Results. Total cholesterol levels overall rose during pregnancy. In the first trimester there is an average decrease of 11.4 mg/dL in total cholesterol level (p < 0.0001) followed by an average increase of 50.5 mg/dL and 28 mg/dL in the second and third trimesters respectively (p < 0.0001). In the year after pregnancy, the levels return to pre- pregnancy levels. LDL and triglyceride levels show a similar pattern. In contrast, HDL-C levels do not change significantly in the first trimester. The second trimester is characterized by an average elevation of 14 mg/dL (p < 0.0001) and a decrease of 5 mg/dL in the third trimester (p = 0.03). The average HDL-C levels of every period tested were lower in the 2nd and 3rd subsequent pregnancies. Conclusions. There is a general increase in total cholesterol, LDL and VLDL during pregnancy. We demonstrate a cumulative effect of consecutive pregnancies on lowering HDL cholesterol levels. This effect may have negative implications on future cardiovascular health.