LDL cholesterol in early pregnancy and offspring cardiovascular disease risk factors

•Studies on relation between maternal LDL-C in pregnancy and offspring risk are scarce.•We measured CVD risk in offspring of women with high or low LDL-C in pregnancy.•LDL-C was higher in 6-to-13-year-old offspring whose mothers had high LDL-C.•The difference in offspring cholesterol is clinically relevant.•Promoting a healthy lifestyle among young women may be particularly beneficial.

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

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