Variación del perfil lipídico durante el embarazo y su relación con las enfermedades metabólicas

María José Aguilar Cordero; María Quirantes Morillas; Tania Rivero Blanco; Ana María Rojas Carvajal; Íñigo María Pérez Castillo; Antonio Manuel Sánchez López

doi:10.19230/jonnpr.4008

Autores/as

María José Aguilar Cordero Departamento de enfermería, Facultad de Ciencias de la Salud, Universidad de Granada. España. Grupo de investigación CTS 367 (PAI). España.
María Quirantes Morillas Hospital Príncipe de Asturias. Alcalá de Henares. Madrid. España.
Tania Rivero Blanco Grupo de investigación CTS 367 (PAI). España.
Ana María Rojas Carvajal Grupo de investigación CTS 367 (PAI). España.
Íñigo María Pérez Castillo Grupo de investigación CTS 367 (PAI). España.
Antonio Manuel Sánchez López Grupo de investigación CTS 367 (PAI). España.

DOI:

https://doi.org/10.19230/jonnpr.4008

Resumen

Introducción. En el embarazo se producen numerosos cambios fisiológicos en las gestantes los cuales pueden llegar a desencadenar potenciales complicaciones y enfermedades cardiovasculares o metabólicas tales como hipertensión gestacional, hiperlipidemia y diabetes mellitus gestacional.

Objetivo. Realizar una revisión sistemática de la literatura con objeto de evaluar la relación entre las variaciones del perfil lipídico durante el embarazo y el riesgo de padecer enfermedades metabólicas y cardiovasculares.

Métodos. Se ha llevado a cabo una revisión sistemática siguiendo las directrices del modelo PRISMA en la que se incluyeron 22 artículos. Los descriptores empleados incluyeron marcadores del perfil lipídico (HDL, LDL, TG y CT) y las principales patologías metabólicas y cardiovasculares. El idioma se restringió a español e inglés. La revisión fue llevada a cabo durante el año 2019.

Resultados. Niveles elevados de colesterol total, LDL y triglicéridos durante el embarazo se asocian con un mayor riesgo de padecer preeclampsia y diabetes mellitus gestacional. Un mayor índice de masa corporal pre gestacional y una mayor ganancia ponderal se relacionan con mayor tasa hiperlipidemia lo cual conlleva a su vez alteraciones vasculares.

Conclusiones. Se hace patente la necesidad de reforzar el control preventivo del peso materno trimestral y del perfil lipídico durante la gestación con objeto de prevenir complicaciones del embarazo. Son necesarios estudios centrados en determinados resultados adversos perinatales tales como la macrosomía del recién nacido.

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Citas

Aguilar MJ, Baena L, Sánchez AM, Guisado R, Hermoso E, Mur N, et al. Nivel de triglicéridos como factor de riesgo durante el embarazo: modelado biológico; revisión sistemática. Nutr Hosp. 2015;32(2):517–27.

Trends in maternal mortality 2000 to 2017: estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division. Geneva: World Health Organization; 2019.

Charlton F, Tooher J, Rye K-A, Hennessy A. Cardiovascular Risk, Lipids and Pregnancy: Preeclampsia and the Risk of Later Life Cardiovascular Disease. Hear Lung Circ . 2014;23(3):203–12.

Sesmero JR, Muñoz P, Solano AM, Odriozola JM, González M, Puertas A, et al. Mortalidad materna en España en el periodo 2010-2012: resultados de la encuesta de la Sociedad Española de Ginecología (SEGO). Progresos Obstet y Ginecol. 2015.

Ryckman K, Spracklen C, Smith C, Robinson J, Saftlas A. Maternal lipid levels during pregnancy and gestational diabetes: a systematic review and meta-analysis. BJOG An Int J Obstet Gynaecol. 2015;122(5):643–51.

Hutton B, Catalá-López F, Moher D. The PRISMA statement extension for systematic reviews incorporating network meta-analysis: PRISMA-NMA. Med Clin. 2016; 147(6):262–6.

Li Y, He J, Zeng X, Zhao S, Wang X, Yuan H. Non-fasting lipids detection and their significance in pregnant women. Lipids in Health and Disease. 2019;96(18).

Petry CJ, Koulman A, Lu L, Jenkins B, Furse S, Prentice P, et al. Associations between the maternal circulating lipid profile in pregnancy and fetal imprinted gene alleles: a cohort study. Reprod Biol Endocrinol. 2018;16(1):82.

Bugatto F, Quintero R, Visiedo FM, Vilar JM, Figueroa A, López-Tinoco C, et al. The Influence of Lipid and Proinflammatory Status on Maternal Uterine Blood Flow in Women With Late Onset Gestational Diabetes. Reprod Sci. 2018;25(6):837–43.

Ghodke B, Pusukuru R, Mehta V. Association of Lipid Profile in Pregnancy with Preeclampsia, Gestational Diabetes Mellitus, and Preterm Delivery. Cureus. 2017.

Keshavarz P, Nobakht M. Gh BF, Mirhafez SR, Nematy M, Azimi M, Afin SA, et al. Alterations in Lipid Profile, Zinc and Copper Levels and Superoxide Dismutase Activities in Normal Pregnancy and Preeclampsia. Am J Med Sci. 2017;353(6):552–8.

Van Lieshout N, Oostvogels AJJM, Gademan MGJ, Vrijkotte TGM. Maternal early pregnancy lipid profile and offspring’s lipids and glycaemic control at age 5–6 years: The ABCD study. Clin Nutr. 2017;36(6):1628–34.

Lekva T, Michelsen AE, Aukrust P, Paasche MC, Henriksen T, Bollerslev J, et al. CXC chemokine ligand 16 is increased in gestational diabetes mellitus and preeclampsia and associated with lipoproteins in gestational diabetes mellitus at 5 years follow-up. Diabetes Vasc Dis Res. 2017;14(6):525–33.

Revankar VM, Narmada L. Assessment of serum ?-hCG and lipid profile in early second trimester as predictors of hypertensive disorders of pregnancy. Int J Gynecol Obstet. 2017;138(3):331–4.

Badillo P, Salgado P, Bravo P, Guevara K, Acurio J, Gonzalez MA, et al. High plasma adenosine levels in overweight/obese pregnant women. Purinergic Signal [Internet]. 2017;13(4):479–88.

Vidakovic AJ, Jaddoe VWV, Voortman T, Demmelmair H, Koletzko B, Gaillard R. Maternal plasma polyunsaturated fatty acid levels during pregnancy and childhood lipid and insulin levels. Nutr Metab Cardiovasc Dis. 2017;27(1):78-85.

Geraghty AA, Alberdi G, O’Sullivan EJ, O’Brien EC, Crosbie B, Twomey PJ, et al. Maternal and fetal blood lipid concentrations during pregnancy differ by maternal body mass index: findings from the ROLO study. Pregnancy and ChildbirthBMC. 2017; 17(1):360.

Shen H, Liu X, Chen Y, HE B, Cheng W. Associations of lipid levels during gestation with hypertensive disorders of pregnancy and gestational diabetes mellitus: a prospective longitudinal cohort study. BMJ Open. 2016;6(12):e013509.

Ryckman KK, Spracklen CN, Smith CJ, Robinson JG, Saftlas AF. Maternal lipids levels during pregnancy and gestational diabetes: a systematic review and meta-analysis. BJOG. 2015;122(5).

Bever AM, Mumford SL, Schisteman EF, Sjaarda L, Perkins NJ, Gerlanc N et al., Maternal preconception lipid profile and gestational lipid changes in relation to birthweight outcomes. Scientific Reports. 2020;1374(10)

Jin W-Y, Lin S-L, Hou R-L, Chen X-Y, Han T, Jin Y, et al. Associations between maternal lipid profile and pregnancy complications and perinatal outcomes: a population-based study from China. BMC Pregnancy Childbirth. 2016;16(1):60.

Bartels A and O’Donoghue K. Cholesterol in pregnancy: a review of knowns and unknowns. Obstetric Medicine. 2011;(4):147-151

Barrett HL, Dekker Nitert M, D’Emden M, McIntyre HD, Callaway LK. Validation of a triglyceride meter for use in pregnancy. BMC Res Notes. 2014;7(1):679.

Vinter CA, Jørgensen JS, Ovesen P, Beck-Nielsen H, Skytthe A, Jensen DM. Metabolic effects of lifestyle intervention in obese pregnant women. Results from the randomized controlled trial ‘Lifestyle in Pregnancy’ (LiP). Diabet Med. 2014; 31(11):1323–30.

Ephraim R, Doe P, Amoah S, Antoh E. Lipid profile and high maternal body mass index is associated with preeclampsia: A case-control study of the Cape Coast Metropolis. Ann Med Health Sci Res. 2014;4(5):746.

Emet T, Üstüner I, Güven SG, Bal?k G, Ural ÜM, Tekin YB, et al. Plasma lipids and lipoproteins during pregnancy and related pregnancy outcomes. Arch Gynecol Obstet. 2013;288(1):49–55.

Scifres CM, Catov JM, Simhan HN. The impact of maternal obesity and gestational weight gain on early and mid-pregnancy lipid profiles. Obesity. 2014;22(3):932–8.

Fraser A, Nelson SM, Macdonald-Wallis C, Cherry L, Butler E, Sattar N, et al. Associations of Pregnancy Complications With Calculated Cardiovascular Disease Risk and Cardiovascular Risk Factors in Middle Age. Circulation. 2012;125(11):1367–80.

Saxena S, Thimmaraju K, Srivastava P, Mallick A, Das B, Sinha N, et al. Role of dyslipidaemia and lipid peroxidation in pregnancy induced hypertension. J Clin Sci Res. 2015;4(3):205.

Mankuta D, Elami-Suzin M, Elhayani A, Vinker S. Lipid profile in consecutive pregnancies. Lipids Health Dis. 2010;9(1):58.

Lekva T, Bollerslev J, Norwitz ER, Aukrust P, Henriksen T, Ueland T. Aortic Stiffness and Cardiovascular Risk in Women with Previous Gestational Diabetes Mellitus. Sanchez-Margalet V, editor. PLoS One. 2015;10(8).

Vrijkotte TGM, Krukziener N, Hutten BA, Vollebregt KC, van Eijsden M, Twickler MB. Maternal Lipid Profile During Early Pregnancy and Pregnancy Complications and Outcomes: The ABCD Study. J Clin Endocrinol Metab. 2012;97(11):3917–25.

Poveda NE, Garcés MF, Ruiz-Linares CE, Varón D, Valderrama S, Sanchez E, et al. Serum Adipsin Levels throughout Normal Pregnancy and Preeclampsia OPEN. Nat Publ Gr. 2016;6:20073.

Nouhjah S, Shahbazian H, Jahanfar S, Shahbazian N, Jahanshahi A, Cheraghian B, et al. Early Postpartum Lipid Profile in Women with and Without Gestational Diabetes Mellitus: Results of a Prospective Cohort Study. Iran Red Crescent Med J. 2017;19(6).

Blagoeva V, Arevalo J, Antolin E & García-Tizón S. Maternal mortality in Spain and its association with country of origin: cross-sectional study during the period 1999–2015. BMC Public Health. 2018;18:1171.