ObjectiveMaternal lipid levels increase in normal pregnancies. Here, we examine whether pregnancies with the highest total cholesterol, low‐density lipoprotein (LDL) or triglyceride levels or the lowest high‐density lipoprotein (HDL) levels predict future dyslipidemia post‐pregnancy.DesignLongitudinal cohort study.SettingFive communities in Michigan, USA.SamplePregnant women (n = 649) with blood lipid levels measured at mid‐pregnancy in the Pregnancy Outcomes and Community Health (POUCH) Study and at the POUCHmoms Study follow‐up, 7–15 years later.MethodsMaternal mid‐pregnancy lipid levels were defined as ‘high’ (upper quartile of triglycerides ≥ 216 mg/dL, LDL ≥ 145 mg/dL and total cholesterol ≥ 256 mg/dL) or ‘low’ (lower quartile, HDL < 58 mg/dL) using whole sample lipid distributions. At follow‐up, dyslipidemia was classified by the clinical cutoffs of triglycerides and total cholesterol ≥ 200 mg/dL, LDL ≥ 130 mg/dL and HDL < 50 mg/dL. Weighted regression models estimated the risk of dyslipidemia at follow‐up in relation to pregnancy lipid levels, adjusted for baseline confounders.Main Outcome MeasureDyslipidemia later in life.ResultsMid‐pregnancy triglycerides, LDL, and total cholesterol levels at the upper quartile were associated with at least threefold increase in the risk of abnormal triglycerides, LDL and total cholesterol levels later in life. Women with low mid‐pregnancy HDL levels had just over a twofold increased risk of abnormally low HDL levels at follow‐up. These associations persisted following adjustment for covariates, i.e. demographics, lifestyle, and years of follow‐up.ConclusionsHigher mid‐pregnancy LDL, total cholesterol and triglycerides and lower levels of HDL may signal future dyslipidemia risk and the need for closer lipid monitoring to ensure timely interventions that can attenuate cardiovascular disease risk.

中文翻译：

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妊娠期和晚年血脂异常的母体脂质：POUCHmoms 纵向队列研究


目的正常妊娠中母体脂质水平升高。在这里，我们检查了总胆固醇、低密度脂蛋白 （LDL） 或甘油三酯水平最高或高密度脂蛋白 （HDL） 水平最低的妊娠是否预示着怀孕后未来的血脂异常。设计纵向队列研究。设置美国密歇根州的五个社区。样本在妊娠结果和社区健康 （POUCH） 研究和 7-15 年后的 POUCHmoms 研究随访中，在怀孕中期测量血脂水平的孕妇 （n = 15）。方法将母亲孕中期血脂水平定义为“高”（甘油三酯上四分位数≥ 216 mg/dL，LDL ≥ 145 mg/dL，总胆固醇≥ 256 mg/dL）或“低”（下四分位数，HDL < 58 mg/dL）使用全样本脂质分布。随访时，根据甘油三酯和总胆固醇的临床临界值≥ 200 mg/dL、LDL ≥ 130 mg/dL 和 HDL < 50 mg/dL 对血脂异常进行分类。加权回归模型估计了随访时与妊娠血脂水平相关的血脂异常风险，并根据基线混杂因素进行了调整。主要结局指标晚年血脂异常。结果妊娠中期甘油三酯、LDL 和上四分位数的总胆固醇水平与以后生活中甘油三酯、LDL 和总胆固醇水平异常风险至少增加三倍相关。妊娠中期 HDL 水平低的女性在随访时 HDL 水平异常低的风险增加了两倍多。这些关联在调整协变量（即人口统计学、生活方式和随访年限）后仍然存在。结论较高的妊娠中期 LDL、总胆固醇和甘油三酯以及较低的 HDL 水平可能预示着未来的血脂异常风险，需要更密切的血脂监测，以确保及时干预，从而降低心血管疾病风险。