Abstract 12115: The Impact of Maternal Dyslipidemia Prior to Pregnancy on Adult Offspring Lipid Levels
INTRODUCTION: Maternal health and in utero exposures are important determinants of cardiovascular disease (CVD) outcomes among adult offspring; however, dyslipidemia has not been as well examined.
HYPOTHESIS: We assessed the hypothesis that maternal dyslipidemia prior to pregnancy imparts a greater risk of offspring dyslipidemia than that of post-pregnancy or paternal dyslipidemia.
METHODS: Analysis of prospectively collected clinical and laboratory data from three generations of Framingham Heart Study (FHS) participants. Exposure measures included serum lipid levels at the parental assessment prior to the offspring’s birth and ~20 years later with an outcome of adult offspring lipids assessed at the offspring’s first assessment in the study. Analysis included multiple linear and logistic regression models, cubic splines, and generalized estimating equations to account for family structure.
RESULTS: There were 789 FHS participants (48% male, average age 23 [SD 5.2] years) with a parental exam prior to their birth. In adjusted models, offspring total cholesterol (TC) was associated with parental TC during maternal pre-pregnancy (β=0.24, p≤0.0001), maternal post-pregnancy (β=0.19, p≤0.0001), and paternal pre-pregnancy (β=0.21, p≤0.0001) assessments. The odds of offspring dyslipidemia with abnormal LDL are presented in Table 1. The adjusted mean offspring LDL was 18 mg/dL (95% CI 9, 27) higher for maternal pre-pregnancy dyslipidemia, 10 mg/dL (95% CI 2, 18) higher for maternal post-pregnancy, and 6 mg/dL (95% CI -1, 13) higher for paternal pre-pregnancy dyslipidemia, as compared to no parental dyslipidemia exposure.
CONCLUSION: The odds of adult dyslipidemia with abnormal LDL are 2-3x larger with maternal pre-pregnancy as compared to post-pregnancy or paternal dyslipidemia. We hypothesize that interventions to reduce dyslipidemia among women prior to pregnancy may modify the vicious trans-generational cycle of dyslipidemia and CVD morbidity.
- © 2013 by American Heart Association, Inc.