Measurement of lipid profiles in the early postpartum period after hypertensive disorders of pregnancy

BACKGROUND: The hypertensive disorders of pregnancy (HDP), including preeclampsia (PE) and gestational hypertension (GHTN), are independent risk factors for future maternal cardiovascular disease. Epidemiologic evidence has demonstrated that women with HDP have abnormal cardiovascular risk factors in the early postpartum period, but this has not been fully characterized. OBJECTIVE: This study aimed to assess the lipid profiles among women with PE, GHTN, and normal blood pressure in the first 4 years postpartum. METHODS: Discharge Abstract Database was used to identify women hospitalized for a delivery in Calgary, Alberta, Canada, between January 2010 and December 2012 (N = 27,300). This was linked with Calgary Laboratory Services (for lipid levels) and the Pharmaceutical Information Network database (for lipid medication prescriptions) over the first 4 years postpartum (2010-2016). Logistic regression analysis was used to compare the frequency of lipid tests among HDP subtypes, adjusted for maternal age, gestational age at delivery, and parity. RESULTS: Only about half of the women with HDP had a lipid test in the first 4 years postpartum: 50.8% (PE) and 48.8% (GHTN) vs 41.5% in normotensive women (P<.001). Low-density lipoprotein cholesterol levels were significantly higher in women with HDP: 106.3 +/- 35.2 mg/dL (2.75 +/- 0.91 mmol/L) in PE, 102.5 +/- 30.5 mg/dL (2.65 +/- 0.79 mmol/L) in GHTN, and 96.7 +/- 29.0 mg/dL (2.50 +/- 0.75 mmol/L) in normotensive women (P <.001). CONCLUSION: Postpartum lipid screening helps identify women at risk of cardiovascular disease; however, only 50% of women with HDP were tested in the first years postpartum. As such, an early opportunity for primary CVD prevention strategies in young women may be lost. (C) 2019 National Lipid Association. All rights reserved.