Effect of obesity on maternal lipids and C-reactive protein

To measure and compare changes in maternal serum lipids and high sensitivity C-reactive protein (hs-CRP) during pregnancy in a group of women with type 3 obesity and a group with normal BMI. The PATH (pregnancy and the heart) study is a prospective longitudinal observational study examining the effect of type 3 obesity on maternal cardiac function during pregnancy. Women with type 3 obesity (BMI > 40) and a control group of lean women (BMI 18-25) were recruited early in pregnancy and evaluated prospectively. In this study, serum lipids and hs-CRP were measured 3 times during pregnancy (<18 weeks, 24 weeks, 36 weeks) and once in the postpartum period (3-6 months after delivery). 25 women with type 3 obesity and 21 controls were recruited to participate. Subjects (mean BMI 46.7) and controls (mean BMI 22.8) were similar with respect to age and parity. Obese women had a blunted peak increase in total cholesterol (13%) compared with lean women (40% increase). Lean women had higher HDL at all measurements and higher peak increases in LDL. Similar elevations in triglycerides were observed. Obese women had higher hs-CRP at all measurements. Obese women do not achieve the same adjustments in serum lipids during pregnancy as lean women. High sensitivity CRP, a strong marker of risk for cardiovascular disease, is significantly higher in obese women during and after pregnancy. The association of these findings with the increased risk of pregnancy complications in obese women and their increased risk for future cardiovascular disease will require further study.