Comparison of Cord Blood Lipid Profile among Hypertensive and Normotensive Mothers: A one year case-control study at KAHERs Dr Prabhakar Kore Hospital and Medical Research Centre, Belagavi

Introduction and Need for the study “The Fetal Origin**of Adult Disease Hypothesis” first popularised by Dr David Barker, proposes a direct link between prenatal nutrition and late-onset coronary heart disease.It is hypothesized that the events occurring in the early placental and fetal development will have a profound effect on one’s risk for developing future adult diseases.The changes in maternal circulation will eventually be reflected on fetal circulation too.Hypertensive disorders in pregnancy are associated with changes in lipid profile which can be detected with cord blood sampling. There is placental dysfunction in pre-eclampsia leading to maternal endothelial dysfunction. Consequently, there will be oxidative stress, dyslipidemia and inflammation. A deranged fetal lipid profile, due to either genetic constitution or gestational nutrition or intrapartum stress can continue to adulthood. Cord blood dyslipidemia is not only a manifestation of pre-eclampsia and but may also play a role in its pathogenesis. Neonates born to hypertensive mothers (including pre-eclampsia) can be targeted and followed up to their adult life for occurrence of coronary artery diseases and dyslipidemia. Despite having a role in the pathogenesis of pre-eclampsia, there is a dearth of knowledge regarding the lipid metabolomics of the cord blood. The normal values of cord blood lipids are not available in our population. Hence, measuring the cord blood lipid profile is easy and feasible to detect the lipid levels at birth in newborns of hypertensive and normotensive mothers. Our study could contribute to developing primary prevention in pre-eclampsia by changing the lipid profiles in suspected mothers who are prone to develop pre-eclampsia. Data Collection Procedure An informed consent will be taken after screening for eligibility Total enrolled study participants will be allotted into group A and group B accordingly and matched according to the age, parity, socio-economic status and mode of delivery. 3 mL venous blood sample will be collected from the mother at the time of admission in plain bulb after admission to labor room/ward under aseptic precautionsand 5 mL of cord blood will be collected using clamping method from placental side of umbilical vein in plain bulb and sent to biochemistry laboratory for lipid profile analysis. After centrifugation, the serums obtained will be analysed for lipid profile by enzymatic method colorimetric method (Cobas Pro by Roche). The values of TC, TG, HDLc, LDLc and VLDLc will be compared of both mother and their baby in both the groups. The immediate maternal and fetal outcome will also be noted. Histopathology reports of placenta with membranes will also be collected of cases with deranged cord blood lipid profile