Gestational Age and Manifest Cardiovascular Risk Factors in Normal Human Pregnancy

Abstract

Normal pregnancy (PREG) is a hyper-physiological state with unique challenges to maternal cardiovascular physiology including alterations in dynamics of lipid metabolism and potential disposition towards cardiovascular disease (CAD) risk with a gestational age (GA) bias. Thus manifestation of known CAD risk factors was evaluated in 75 human females, randomly assigned to 3 groups each of 25 subjects of different GA. Group1 served as Control (NO PREG), Groups 2 and 3 were PREG at GA of less than 20weeks (PREG<20wk) and of 20weeks or more (PREG ≥ 20wk) respectively. Following anthropometric and relevant obstetric history determination, anticoagulated blood samples were asceptically collected and clean plasma samples obtained for enzymatic determination of plasma concentrations of fasting blood sugar (FBS) and various lipid compartments: triglycerides (TRG), total cholesterol (CHOL) - (TPC), and high density lipoprotein CHOL (HDLc). Plasma low density lipoprotein CHOL (LDLc) concentration was estimated according to 1 Okwusidi (1988). CHOL was compartmentalized in TPC and HDLc fractions. LDLc compartment was notably lesser. TRG/VLDLc fraction was the least of lipid compartments. TPC in PREG < 20wk was similar to Control value. All primary lipid variables in PREG ≥ 20wk were significantly (p< 0.05) elevated when compared to either the Control or PREG < 20wk. TPC and LDLc based AI were similar in both Control and PREG < 20wk. Only the TRG/VLDLc based AI of the group varied significantly in PREG < 20wk compared to Control (p< 0.05). All compartmental AI in PREG ≥ 20wk were significantly elevated compared to Control or PREG < 20wk. FBS concentration were similar in all study groups. The bulk of CAD risk potential was contributed by TPC/HDLc RAI and TRG/HDLc RAI respectively. The dreaded “bad” LDLc/HDLc RAI potential was essentially the same in Control and pregnant subjects (25%, 22%, 27%: Control, PREG < 20wk, PREG ≥ 20wk respectively). These results strongly suggest that normal pregnant state is not deleteriously or propathologically disposed towards GA accentuated CAD risk.