Pregnant Patients with Preexisting High Cholesterol May Have Elevated Cardiovascular Risk, According to New Research from Allegheny General Hospital

Abstract Presented at American College of Cardiology Conference Showed High Lipid Levels in Obstetric Patients May Result in Adverse Labor and Delivery and Cardiac Outcomes

PITTSBURGH - Pregnant patients with pre-existing hyperlipidemia (high cholesterol) may be at risk for obstetric complications as well as cardiovascular events within the first five postpartum years, according to new research presented by clinicians from Allegheny Health Network's (AHN) Allegheny General Hospital (AGH) at this month's American College of Cardiology Conference.

Srijana Maharjan, MD, Cali Clark, DO, Mariah Mascara, MD, Yochitha Pulipathi, MD, Sanchaya Khetrapal, MD, and Mahathi Indaram, MD were lead authors of the abstract, "Effect of Hyperlipidemia on Pregnancy and Cardiovascular Outcome in Pregnant Women."

Hyperlipidemia (high cholesterol) occurs when there is an excess of lipids or fats in the blood, restricting the blood flow through the arteries and increasing the risk of heart attack or stroke. The condition has become increasingly common among younger women in response to the rising rates of metabolic syndrome, obesity, and sedentary lifestyles.

"High cholesterol is a prevalent, modifiable risk factor for coronary heart disease, yet its role in pregnancy-related outcomes and long-term maternal cardiovascular health remains under-investigated," explained Dr. Indaram, an author of the study and a lead clinician at the AHN Cardio-Obstetrics Clinic. "Our hope is that by deepening our understanding of how high cholesterol impacts the physiology of the body during pregnancy, we can better tailor our screening and prevention therapies - before, during and well after the gestation period.

AGH clinicians identified more than 10,000 women with pre-pregnancy hyperlipidemia across 66 U.S. health care systems from 2000 to 2020. The study cohort included pregnant women, 18 or older, with hyperlipidemia.

The results found that women with high cholesterol had higher risks of arrhythmia, acute coronary syndrome, antepartum hemorrhage, gestational diabetes, labor and delivery complications, and hypertensive disorders of pregnancy, compared to women without the pre-existing diagnosis of hyperlipidemia.

"There are various factors that could contribute to these findings, as high cholesterol in the body can cause significant inflammation and hardened arteries, which can lead to complications," continued Dr. Indaram. "However, we have known for decades that pregnancy is typically a woman's first stress test for the heart, and these findings further underscore that belief."

AGH clinicians encourage obstetricians to work closely with their cardiac colleagues in patient cases with pre-pregnancy hyperlipidemia, incorporate lipid screening into preconception care and closely monitor women with hyperlipidemia during and after pregnancy.

Since early 2023, AHN has maintained a dedicated, multidisciplinary cardio-obstetrics clinic at its West Penn Hospital location to care for patients diagnosed with cardiovascular disease who are pregnant, trying to conceive, or in the postpartum period. The clinic is a collaborative partnership between the AHN Women's Institute and AHN Cardiovascular Institute.

For more information on the AHN Cardio-Obstetrics clinic or to make an appointment, call 412-359-4744.

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