Background Trigyliceridaemia is a major feature of the metabolic syndrome. In pre-eclampsia, the normally adaptive physiological responses in pregnancy are exaggerated. Gestational hyperlipidaemia is one of the significant changes that occur. The aetiology of pre-eclampsia may be related to endothelial damage from triglycerides.

Objective To evaluate the association between raised triglycerides in pregnancy and pre-eclampsia by systematic review.

Methods We searched MEDLINE (1950-2011), EMBASE (1980-2011), CINAHL (1981-2011), Web of Science, ProQuest, metaRegister, Conference Proceedings Citation Index, The Cochrane library and reference lists of relevant studies. Two reviewers independently selected studies and extracted data. Studies on pregnant women that compared the triglycerides level between women with pre-eclampsia and normal pregnancy were included. Mean differences from individual studies were meta-analysed using random effects model.

Results Of the 1017 citations identified, 28 studies were included. Meta-analysis of the 28 studies showed that pre-eclampsia was associated with higher levels of serum triglycerides (SMD 0.92, 95% CI 0.68 to 1.16, p<0.00001) compared to normal pregnancies. The sub-group analysis according to the gestational age showed that triglycerides were significantly higher (p<0.00001) in the third trimester (SMD 1.15, 95% CI 0.80 to 1.50) compared to the second trimester (SMD 0.43, 95% C I 0.15 to 0.70) or post-partum (SMD 0.60, 95% CI 0.41 to 0.80).

Conclusion Hypertriglyceridimia is a signicant risk factor for pre-eclampsia especially in the third trimester. Future studies on pre-eclampsia should evaluate the role of lipid lowering interventions in preventing pre-eclampsia.