No abstract

Lipid profiles were estimated in two groups of normal healthy women comprising 39 non-pregnant women and 67 pregnant women at 28 and 32 weeks gestation and 6 weeks after delivery. Triglycerides, total, HDL and LDL cholesterols were high during pregnancy. Except for LDL cholesterols which remained constant, all the above decreased at 6/52 postnatally, but levels were still above those of normal non-pregnant women. Compared to the later, the atherogenic index, LDL/HDL cholesterol ratio was unchanged during pregnancy but significantly increased at 6/52 postnatally. These results may suggest that while total lipid levels increase during pregnancy, this is balanced by an even distribution of the lipoprotein fractions. After delivery, though lipid levels had decreased, the decrease in HDL cholesterol and increase in LDL cholesterol caused unfavourable changes in lipid-lipoprotein ratios. These changes may be due to the change in metabolism of the pregnant women as well as diet during and after pregnancy.

Serum paraoxonase (EC 3.1.1.2) may be implicated in the lipid metabolism. In order to substantiate this view we conducted a longitudinal study of interrelationships of serum paraoxonase, lipids and apolipoproteins during pregnancy. Fasting serum levels of paraoxonase, serum lipids (total, HDL and LDL cholesterols, triglycerides) and apolipoproteins (AI, All and B) were estimated in 91 pregnant women at 28 and 32 weeks of gestation and 6 weeks after delivery, and 40 nonpregnant women. Serum paraoxonase, total HDL and LDL cholesterol levels were significantly higher during pregnancy along with corresponding apolipoprotein (p < 0.001). The most striking increase was seen in serum triglycerides and paraoxonase levels (p < 0.001). Serum paraoxonase levels had a significant correlation with triglycerides (r: 0.45–0.60) and ApoAH (r: 0.32–0.41) in both pregnant and nonpregnant states (p < 0.001). Moreover, both serum paraoxonase and triglyceride levels at 28 weeks of pregnancy were negatively correlated with birth weight (r: 0.3, p < 0.05), suggesting a possible role of paraoxonase in energy delivery for fetal development derived from maternal hypertriglyceridemia.

Norplant implant use in Singapore showed a decrease in vitamin K-dependent Factors II, V, VII and reduction in fibrinolytic activity at the end of 5 years of use. Increased platelet numbers and accelerated platelet aggregation were also found throughout the 5 years of Norplant use. It thus appears that unlike the combined pill, prolonged Norplant use does not activate the coagulation system and does not enhance a state of hypercoagulation. On removal of the Norplant implants at the end of 5 years, the significant changes seen in hemostatic function observed with Norplant use remained.