Maternal hypercholesterolemia during gestation is associated with elevated lipid levels of two-day-old neonates.

Maternal hypercholesterolemia (MHC) during pregnancy is associated with the risk of developing aortic lesions in fetuses. There is also a possibility of faster progression of atherosclerosis in offspring born to hypercholesterolemic mothers (HCM) during their adulthood. We investigated whether elevated maternal cholesterol levels during pregnancy influence the lipid levels in offspring. We analyzed the lipid profile of mothers during the three trimesters, cord blood (CB) at birth, and neonatal blood (NB) on Day 2 postpartum in the offspring. Cholesterol levels of HCM significantly increased throughout gestation when compared to normocholesterolemic mothers (NCM). CB lipid levels of newborns of HCM were similar to the newborns of NCM. While NB of offspring of HCM had elevated levels of triglycerides (TG) (p < 0.01) and very low-density lipoprotein (VLDL) (p < 0.01) when compared to the offspring of NCM. MHC also resulted in low newborn birthweight (p < 0.05) and low placental efficiency (ratio of newborn birth weight to placental weight) (p < 0.01) but no change was observed in umbilical cord length or placental weight. Immunohistochemical analysis revealed no significant changes in the protein expression of genes involved in TG metabolisms such as LDLR, VLDLR, CETP, and PPARG. We report that MHC in mothers decreases placental efficiency and newborn birthweight while increasing lipid levels in neonates on the second postpartum day. Given that TG levels modulate the circulating Low-Density lipoproteins, the increase in these levels in neonates gains importance. Whether these consistently high levels cause atherosclerosis in early adulthood warrants further investigation.

Maternal cholesterol levels during gestation: boon or bane for the offspring?

An increase in cholesterol levels is perceived during pregnancy and is considered as a normal adaptive response to the development of the fetus. In some pregnancies, excessive increase in total cholesterol with high levels of Low-Density Lipoprotein leads to maladaptation by the fetus to cholesterol demands, resulting in a pathological condition termed as maternal hypercholesterolemia (MH). MH is considered clinically irrelevant and therefore cholesterol levels are not routinely checked during pregnancy, as a consequence of which there is scarce information on its global prevalence in pregnant women. Studies have reported that MH during pregnancy can cause atherogenesis in adults emphasizing the concept of in utero programming of fetus. Moreover, Gestational Diabetes Mellitus, obesity and Polycystic Ovary Syndrome are potential risk factors which strengthen combined pathologies in placenta and fetuses of mothers with MH. However, lack of conclusive evidence on cholesterol transport and underlying programming demand substantial research to develop population-based life style strategies for women in their childbearing years. The current review focuses on the mechanisms and outcomes of MH from existing epidemiological as well as experimental data and presents a detailed insight on this novel risk factor of cardiovascular diseases.