(756) Postpartum Lipid Screening in Patients with Pregestational Diabetes

To characterize lipid profiles within the first year postpartum among individuals with diabetes mellitus (DM), a high-risk, predominantly young population not captured in traditional 10-year cardiovascular disease (CVD) risk calculators.

Study Design:

This is a prospective observational study of postpartum patients with pregestational DM enrolled in a comprehensive postpartum care program. Individuals who delivered October 2020 - October 2024 and had at least one lipid panel beyond 3 months postpartum were included. Hemoglobin A1c (HbA1c) levels were also measured at this time. Demographic and clinical data were abstracted from the medical record. Lipid levels were compared by stratified HbA1c values using Kruskal-Wallis test.

Results:

Of 151 eligible patients, 68 (45%) underwent lipid screening. The median age was 33 years, with 82% under age 40. Most had type 2 DM (91%) and/or hypertension (44.3%). Median lipid values were: total cholesterol 195 [162, 229]; LDL 107 [86, 137]; HDL 46 [38, 53]; and triglycerides 171 [117, 232] (Table 1). Overall, 46% had total cholesterol ≥ 200mg/dL, 12% had LDL ≥ 160mg/dL, and 59% had triglycerides ≥ 150mg/dL. Notably, 90% of patients had an LDL ≥ 70mg/dL, the recommended target value for primary prevention of atherosclerotic CVD in those with high-risk conditions such as DM. Total cholesterol, LDL, HDL, and triglycerides did not vary significantly with worsening hemoglobin A1c values (Table 2).

Conclusion:

Although increasing HbA1c was not significantly associated with changes in lipid levels, triglyceride levels were frequently elevated in this high-risk cohort. While primary prevention guidelines are well established for patients aged 40 and older, there are limitations to current cardiovascular risk calculators in younger populations. This study highlights the need for targeted prevention strategies in at-risk postpartum patients.