Role of lipid profile in early second trimester for prediction of pre-eclampsia

Background: The aim of the study was to determine association of abnormal lipid profile in early second trimester (14 to 20 weeks) with development of pre-eclampsia.Methods: A prospective observational study included 260 women between 14-20 weeks of pregnancy attending a tertiary care Hospital in New Delhi. Serum lipid profile analysis was performed at the time of enrolment and cohort was followed up for occurrence of pre-eclampsia till 48 hours after delivery. Outcomes measured were difference in mean lipid levels in study (abnormal lipid profile) and control group (normal lipid profile) and accuracy of abnormal lipid profile to predict pre-eclampsia.Results: The incidence of pre-eclampsia in our study was 11.13%. The mean serum total cholesterol was significantly higher in pre-eclampsia group (199.74 mg/dl vs 171.7 mg/dl; p<0.05). The difference in mean triglyceride, HDL, VLDL and LDL levels between two groups was not significant. Total cholesterol has 44.83% sensitivity, 84.85% specificity, 27.08% PPV, 92.45% NPV with diagnostic accuracy of 80.38% in predicting pre-eclampsia (with 0.65% AUC with 95% confidence interval). While VLDL has maximum sensitivity of 68.97% while HDL has maximum specificity of 86.15% in predicting pre-eclampsia.Conclusions: Abnormal total cholesterol levels have diagnostic accuracy of 80.38% to predict pre-eclampsia and abnormal lipid profile in early second trimester is a simple, non-invasive and economical test for prediction of pre-eclampsia.