Key result
High levels of lipoprotein(a) (>30 mg/dl) in pregnant women with uteroplacental insufficiency were associated with a significantly higher prevalence of preeclampsia (p < 0.001).
Why the study?
Are elevated lipoprotein(a) levels associated with uteroplacental vascular disease and adverse pregnancy outcomes?
Observational (n=143)
Are elevated lipoprotein(a) levels associated with uteroplacental vascular disease and adverse pregnancy outcomes?
p-value: p=< 0.001
Elevated lipoprotein(a) levels are associated with uteroplacental insufficiency, preeclampsia severity, and adverse fetal outcomes.
Lp(a) elevation in preeclampsia should not yet guide care; leaves open its role as a vascular biomarker in pregnancy.
OBJECTIVE: To study maternal lipoprotein(a) levels in normal pregnancy and in pregnancy with evidence of vascular disease in the maternal uteroplacental circulation defined by Doppler ultrasound study. SAMPLES: Maternal venous blood was collected from 75 normal pregnant women and 68 pregnant women with evidence of potential uteroplacental vascular disease identified by Doppler ultrasound study. METHODS: Plasma lipoprotein(a) levels in maternal blood were measured using an enzyme-liked immunosorbent assay method. MAIN OUTCOME MEASURES: Plasma lipoprotein(a) levels and pregnancy outcome were examined. RESULTS: None of the normal group had lipoprotein(a) levels greater than 30 mg/dl, a cutoff level which has been associated with increased risk of atherosclerosis. 28 of the 68 women with uteroplacental insufficiency had lipoprotein(a) levels greater than this cutoff level. In this group there was a statistically significant higher prevalence of preeclampsia in comparison with women with a normal lipoprotein(a) level (p < 0.001). The lipoprotein(a) level was significantly higher in severe (n = 13, median 60.5 mg/dl, P < 0.001] than in mild preeclampsia (n = 5, median 34 mg/dl). Those with high levels (> 30 mg/dl) exhibited significantly more adverse indices of fetal outcome. CONCLUSION: This study has demonstrated that high levels of lipoprotein(a) interfere with uteroplacental circulation and play a role in the pathophysiology of preeclampsia. Lipoprotein(a) concentrations are associated with the severity of the disease. We suggest that high levels of lipoprotein(a) might affect the placenta and fetus.
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Mori et al. (2003) conducted an observational in Pregnancy with and without uteroplacental vascular disease (n=143). High lipoprotein(a) levels (> 30 mg/dl) vs. Normal lipoprotein(a) levels (≤ 30 mg/dl) was evaluated on Prevalence of preeclampsia (p=< 0.001). High levels of lipoprotein(a) (>30 mg/dl) in pregnant women with uteroplacental insufficiency were associated with a significantly higher prevalence of preeclampsia (p < 0.001).
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