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Maternal and neonatal outcomes in women with disorders of lipid metabolism

Emmy Cai, Nicholas Czuzoj-Shulman, Isabelle Malhamé and Haim A. Abenhaim

Abstract

Objectives

The effects of lipid metabolism disorders (LMD) on pregnancy outcomes is not well known. The purpose of this study is to evaluate the impact of LMD on maternal and fetal outcomes.

Methods

Using the Healthcare Cost and Utilization Project – National Inpatient Sample from the United States, we carried out a retrospective cohort study of all births between 1999 and 2015 to determine the risks of complications in pregnant women known to have LMDs. All pregnant patients diagnosed with LMDs between 1999 and 2015 were identified using the International Classification of Disease-9 coding, which included all patients with pure hypercholesterolemia, pure hyperglyceridemia, mixed hyperlipidemia, hyperchylomicronemia, and other lipid metabolism disorders. Adjusted effects of LMDs on maternal and newborn outcomes were estimated using unconditional logistic regression analysis.

Results

A total of 13,792,544 births were included, 9,666 of which had an underlying diagnosis of LMDs for an overall prevalence of 7.0 per 10,000 births. Women with LMDs were more likely to have pregnancies complicated by diabetes, hypertension, and premature births, and to experience myocardial infarctions, venous thromboembolisms, postpartum hemorrhage, and maternal death. Their infants were at increased risk of congenital anomalies, fetal growth restriction, and fetal demise.

Conclusions

Women with LMDs are at significantly higher risk of adverse maternal and newborn outcomes. Prenatal counselling should take into consideration these risks and antenatal care in specialized centres should be considered.


Corresponding author: Haim A. Abenhaim, MD MPH, Department of Obstetrics & Gynecology, Jewish General Hospital, McGill University, 3755 Chemin de la Côte-Sainte-Catherine, H3T 1E2, Montreal, QC, Canada; and Centre for Clinical Epidemiology, Jewish General Hospital, Montreal, QC, Canada, Phone: 514-340-8222 x 24187, Fax: 514-340-7564, E-mail:

  1. Research funding: None declared.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: This study was solely based on a preexisting database from the United States that is freely available to the public: Healthcare Cost and Utilization Project Nationwide Inpatient Sample (HCUP-NIS).

  5. Ethical approval: The local Institutional Review Board deemed the study exempt from review.

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Received: 2021-01-19
Accepted: 2021-05-18
Published Online: 2021-07-01

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