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


  • Surbhi . Department of Obstetrics and Gynecology, ABVIMS and Dr RML Hospital, New Delhi, India
  • Bangali Majhi Department of Obstetrics and Gynecology, ABVIMS and Dr RML Hospital, New Delhi, India



Cholesterol, HDL, LDL, Pre-eclampsia, Triglyceride, VLDL


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.



Duley L. The global impact of pre-eclampsia and eclampsia. Semin Perinatol. 2009;33(3):130-7.

Gestational hypertension and preeclampsia. ACOG Practice Bulletin No. 222. American College of Obstetricians and Gynecologists. Obstet Gynecol 2020;135:237-60.

Cunningham FG, Leveno KJ, Bloom SL, Dashe JS, Hoffman BL, Casey BM, et al. Williams Obstetrics. 25th ed. New York, NY: McGraw Hill;1918: 725.

Gant NF, Daley CL, Chand S, Whalley PJ, Macdonald PC. A study of angiogenesis II pressor response throughout primigravida pregnancy. J Clin Invest 1973;52:2682-9.

Page EW, Christianson R. The impact of mean arterial pressure in the middle trimester upon the outcome of pregnancy. Am J Obstet Gynecol. 1976;125(6):740-6.

Ales KL, Norton ME, Druzin ML. Early prediction of antepartum hypertension. Obstet Gynecol. 1989;73(6):928-33.

Cnossen JS, Ruyter H, Post JA, Mol BW, Khan KS, Riet G. Accuracy of serum uric acid determination in predicting pre-eclampsia: a systematic review. Acta Obstet Gynecol Scand. 2006;85(5):519-25.

Pouta AM, Hartikainen AL, Vuolteenaho OJ, Ruokonen AO, Laatikainen TJ. Midtrimester N-terminal proatrial natriuretic peptide, free beta hCG, and alpha-fetoprotein in predicting preeclampsia. Obstet Gynecol. 1998;91(6):940-4.

Kang JH, Farina A, Park JH, Kim SH, Kim JY, Rizzo N, et al. Down syndrome biochemical markers and screening for preeclampsia at first and second trimester: correlation with the week of onset and the severity. Prenat Diagn. 2008;28(8):704-9.

Festa A, Agostino R, Howard G, Mykkanen L, Tracy RP, Haffner SM. Chronic subclinical inflammation as part of the insulin resistance syndrome: the Insulin Resistance Atherosclerosis Study (IRAS). Circulation. 2000;102(1):42-7.

Aquilina J, Barnett L, Thompson O, Harrington K. Comprehensive analysis of uterine artery flow velocity waveforms for the prediction of preeclampsia. Ultrasound Obstet Gynecol 2000; 16:163-70.

Cunningham FG, Leveno KJ, Bloom SL, Dashe JS, Hoffman BL, Casey BM, et al. Williams Obstetrics. 25th ed. New York, NY: McGraw Hill;1918: 1259.

Vidyabati RK, Davina H, Singh NK, Singh W. Gyaneshwar-Serum β hCG and lipid profile in early second trimester as predictors of Pregnancy induced hypertension. J Obstet Gynecol India. 2010;60(1):44-50.

Ewa AM, Berry SA, Salama KM, Maghraby NY. Lipids and uric acid in midsecond trimester and prediction of adverse pregnancy outcome. Benha Med J. 2018; 35:145-9.

Yadav K, Aggarwal S, Verma K. Serum βhCG and Lipid Profile in Early Second Trimester as Predictors of Pregnancy-Induced Hypertension. J Obstet Gynaecol India. 2014;64(3):169-74.

Kumari K, Singh U, Maharshi S, Singh R. Assessment of serum lipid profile in early pregnancy and its relation with pre-eclampsia: a prospective study. Int J Reprod Contracept Obstet Gynecol. 2016;5:840-4.

Siddiqui I. Maternal Serum Lipids in Women with Pre-eclampsia. Ann Med Health Sci Res. 2014;4(4):638-41.

Iftikhar U, Iqbal A, Shakoor S. Relationship between leptin and lipids during preeclampsia. J Pak Med Assoc. 2010;60(6):432‐5.

Singh A, Kujur A, Jain P. Fetomaternal impact of altered lipid profile in pregnancy. Int J Reprod Contracept Obstet Gynecol. 2018;7:132-6.






Original Research Articles