Maternal Serum Lipids in Pre-Eclamptic and Normotensive Pregnant Women: A Case-Control Study

Background: Preeclampsia-eclampsia is a major contributor to maternal and fetal, morbidity and mortality especially in low to middle income countries. This hypertensive disorder of pregnancy remains a disease of theories due to its unclear etiology. We evaluated for possible associations between maternal serum lipids and preeclampsia. Methods: This was a prospective case-control study that recruited 60 consenting women diagnosed with preeclampsia (cases) and 60 normotensive healthy pregnant women (controls), matched for maternal age and gestational age over an 8-month period (18th June, 2014 to 18th February, 2015) at the Federal Teaching Hospital Ido-Ekiti, Nigeria. Cases and controls were recruited using the non-probability convenience sampling. Fasting venous blood samples were collected in both cases and controls and analyzed for serum total cholesterol (TC), triglycerides (TG), high density lipoproteins (HDL) and low density lipoproteins (LDL) using Randox standard enzymatic methods. Data obtained were analyzed using SPSS version 18 to compare and test for significance using Student t-test, Chi-square, and Pearson’s correlation as the appropriate. Tests of association were determined using logistic regression models. The difference was considered significant at P < 0.05. Findings: The mean serum levels of TC, HDL and LDL were significantly (p < 0.001) higher in the pre-eclamptics (6.6 ± 2.9 mmol/L, 2.1 ± 1.0 mmol/L and 3.6 ± 2.6 mmol/L) than in normotensive women (4.5 ± 1.3 mmol/L, 1.5 ± 0.9 mmol/L and 2.2 ± 1.2 mmol/L) respectively. Mean serum level of triglycerides was increased in the pre-eclamptics (2.0 ± 1.0 mmol/L) compared to the controls (1.8 ± 0.6 mmo/L) (p = 0.089). Serum TC, TG and LDL were similar in women with mild preeclampsia when compared with women with severe preeclampsia. Correlation between maternal systolic and diastolic blood pressures and the serum lipids was not significant. Adjusted multivariate logistic regression analysis revealed that total cholesterol (OR = 4.363, 95% CI = 1.410 - 13.506, p = 0.011) and high density lipoproteins (OR = 3.247, 95% CI = 1.086 - 9.709, p = 0.035) are significant independent risk factors for preeclampsia. Conclusion: Elevated maternal serum lipids are associated with preeclampsia, however, the widespread lack of uniformity in the patterns of dyslipidemias in pre-eclamptics, across different populations, may suggest that serum lipids will not be a reliable predictor or severity marker of preeclampsia.

A STUDY ON THE SERUM PREGNANCY ZONE PROTEIN LEVELS IN PREGNANT WOMEN AND PATIENTS WITH GYNECOLOGICAL TUMORS

In this study, the serum levels of the pregnancy zone protein (PZP) were determined by PZP-single radial immunodiffusion in 708 cases of normal pregnancy, 207 with abormal pregnancy and 188 with gynecological tumors. The results indicated that serum PZP levels in the normal pregnancy was detectable 5 weeks after gestation. It increased with the advance of gestational weeks, and reached a peak level in week 40. The serum PZP levels in 81.7% of patients with threatened abortion but not aborted were within the normal range, and also mostly in those with pregnancy-nduced hypertension, intrauterine growth retardation (IUGR), anencepbalus and ectopic pregnancy; the serum PZP levels in 51.6% of patients with invasive moles and 80.0% with choriocarcinoma, respectively, were lower than in normal controls. In gynaecological tumors, the serum PZP levels were significantly higher in patients with ovarian carcinomas than in those with other ovarian tumors (P<0.01), and in those with endometrial or cervical carcinoma than in those with uterine myomas (P<0.01). These results suggest that measuring the serum PZP levels may be used as an important reference index to observe threatened abortion and to identify trophoblastic diseases and gynecological tumors.