LDL cholesterol in early pregnancy and offspring cardiovascular disease risk factors.

BACKGROUND

Vast amounts of data show associations between maternal obesity, dysglycemia, diabetes, and undernutrition during pregnancy and increased cardiovascular disease risk in offspring. However, elevated maternal LDL cholesterol (LDL-C) in pregnancy and offspring cardiovascular disease (CVD) risk has scarcely been studied.

OBJECTIVE

Our objective was to investigate the associations between elevated maternal LDL-C in pregnancy and CVD risk factors in 6-to-13-year-old offspring.

METHODS

We recruited 6-to-13-year-old children whose mothers attended a pregnancy cohort and who had high or low cholesterol in pregnancy, defined as LDL-C over the 90th percentile or below the 10th percentile within the pregnancy cohort, respectively. We measured CVD risk factors in the children in the 2 groups.

RESULTS

Maternal plasma LDL-C at gestational week 14 to 16 was 4.0 and 1.4 mmol/L in the hypercholesterolemic (n = 27) and hypocholesterolemic (n = 34) groups, respectively (P < .001). Interestingly, offspring plasma LDL-C was 0.4 mmol/L higher in children whose mothers had hypercholesterolemia during pregnancy (P < .01). We found no difference in birthweight or any other clinical or biochemical CVD risk factors or dietary intake between the children at 6-13 years.

CONCLUSIONS

Women with elevated LDL-C during early pregnancy have offspring with higher LDL-C already at the age of 6-13 years. Unless cholesterol-reducing measures are successfully implemented, the affected children may be at increased cardiovascular risk.