Maternal hyperlipidemia and the risk of preeclampsia: a meta-analysis

Am J Epidemiol. 2014 Aug 15;180(4):346-58. doi: 10.1093/aje/kwu145. Epub 2014 Jul 2.


Published reports examining lipid levels during pregnancy and preeclampsia have been inconsistent. The objective of this meta-analysis was to test the association between preeclampsia and maternal total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), non-HDL-C, and triglyceride levels measured during pregnancy. We conducted a systematic search for studies published between the index date until July 2013 reporting maternal lipid levels in women with preeclampsia and normotensive pregnant women. Seventy-four studies met all eligibility criteria and were included in the meta-analysis. Weighted mean differences in lipid levels were calculated using a random-effects model. Statistical heterogeneity was investigated using the I(2) statistic. Meta-regression was used to identify sources of heterogeneity. Preeclampsia was associated with elevated total cholesterol, non-HDL-C, and triglyceride levels, regardless of gestational age at the time of blood sampling, and with lower levels of HDL-C in the third trimester. A marginal association was found with LDL-C levels. Statistical heterogeneity was detected in all analyses. Meta-regression analyses suggested that differences in body mass index (weight (kg)/height (m)(2)) across studies may be partially responsible for the heterogeneity in the triglyceride and LDL-C analyses. This systematic review and meta-analysis demonstrates that women who develop preeclampsia have elevated levels of total cholesterol, non-HDL-C, and triglycerides during all trimesters of pregnancy, as well as lower levels of HDL-C during the third trimester.

Keywords: body mass index; cholesterol; hyperlipidemia; hypertriglyceridemia; meta-analysis; preeclampsia; systematic review; triglycerides.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Cholesterol / blood
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • Female
  • Humans
  • Hyperlipidemias / blood
  • Hyperlipidemias / complications*
  • Pre-Eclampsia / blood
  • Pre-Eclampsia / etiology*
  • Pregnancy
  • Risk Factors
  • Triglycerides / blood


  • Cholesterol, HDL
  • Cholesterol, LDL
  • Triglycerides
  • Cholesterol