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Pre‐eclampsia is associated with, and preceded by, hypertriglyceridaemia: a meta‐analysis
Author(s) -
Gallos ID,
Sivakumar K,
Kilby MD,
Coomarasamy A,
Thangaratinam S,
Vatish M
Publication year - 2013
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.12375
Subject(s) - eclampsia , medicine , confidence interval , meta analysis , cochrane library , triglyceride , obstetrics , pregnancy , cholesterol , biology , genetics
Background Elevated triglycerides are a feature of the metabolic syndrome, maternal obesity, maternal vasculitis (i.e. systemic lupus erythematosus) and diabetes mellitus. These conditions are all known risk factors for pre‐eclampsia. Hypertriglyceridaemia therefore may be associated with pre‐eclampsia and indeed this may precede the presence of overt disease. Objective In this study we determine the association between hypertriglyceridaemia and pre‐eclampsia in pregnant women. Search strategy We searched MEDLINE , EMBASE , Web of Science, Excerpta Medica Database, ISI Web of Knowledge, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library from inception until June 2012 and reference lists of relevant studies. Selection criteria Two reviewers independently selected studies on pregnant women where triglycerides were measured and women were followed up until the development of pre‐eclampsia or selected on the basis of presence of pre‐eclampsia and compared with controls. Data collection and analysis We collected and meta‐analysed the weighted mean differences ( WMD s) of triglyceride levels from individual studies using a random effects model. Main results We found strong evidence from meta‐analysis of 24 case–control studies (2720 women) that pre‐eclampsia is associated with higher levels of serum triglycerides ( WMD 0.78 mmol/l, 95% confidence interval 0.6–0.96, P < 0.00001). This finding is also confirmed in five cohort studies, that recruited 3147 women in the second trimester before the onset of pre‐eclampsia, which proves that hypertriglyceridaemia precedes the onset of pre‐eclampsia ( WMD 0.24 mmol/l, 95% confidence interval 0.13–0.34, P < 0.0001). Author's conclusions Hypertriglyceridaemia is associated with and precedes the onset of pre‐eclampsia. Further research should focus on defining the prognostic accuracy of this test to identify women at risk and the beneficial effect of triglyceride‐lowering therapies in pregnancy.