https://doi.org/10.15218/ejnm.2025.03 Erbil j. nurs. midwifery, Vol. 8, No. (1), May 2025 Original Article Effect of Serum Lipid Profile and Renal Functions during Pregnancy and its associated diseases in Sulaimanyah / Kurdistan Region ABSTRACT Background and Objective: The physiological function of the kidneys poses significant challenges during pregnancy, impacting maternal and fetal health. Understanding the in- terplay between renal functions and serum lipid profiles is crucial for managing maternal health. This study aims to investigate serum lipid profiles and their association with renal function in pregnancy and compare them with non-pregnant status. The objective of this study was to conduct a prospective analysis of blood lipid concentration, namely lipopro- tein, as well as the rates of urea and creatinine, in pregnant women, and thereafter com- pare these measurements with those of non-pregnant women. Methods: A case- control study was conducted on pregnant women in Sulaimanyah/ Kurdistan. Both serum lipid profile tests, including triglycerides, cholesterol, and lipopro- tein levels, and renal function markers, such as serum creatinine, urea, and estimated glo- merular filtration rate, were measured at various stages of pregnancy. Data was analyzed by the Statistical Package for the Social Sciences version 22.0 to identify correlations be- tween serum lipid profile, renal function, and pregnancy outcomes. Results: This study highlights significant positive correlations of low-density lipoprotein with gestation age, cholesterol, triglyceride, and high-density lipoprotein, alongside strong negative correlations with total serum bilirubin and creatinine in pregnancy. This correlation was not found in non-pregnant status. Additionally, estimated glomerular fil- tration rate exhibits strong positive correlations with cholesterol and low-density lipopro- tein and negative correlations with total serum bilirubin and creatinine.In non-pregnant individuals, estimated glomerular filtration rate moderately correlates with random blood sugar while strongly correlating negatively with urea and creatinine.Mean ± Standard de- viation of urea and creatinine were significantly higher in non-pregnant women while cholesterol and estimated glomerular filtration rate were significantly high among preg- nant women. Conclusion: This study highlighted notable metabolic disparities between pregnant and non-pregnant women, particularly in terms of lipid profiles and renal function. Changes in hormone levels during pregnancy can elevate lipid profiles and renal function, and these metabolic and hormonal changes could affect kidney function indicators. Keywords: Renal Function (RF); Pregnancy; Estimated Glomerular Filtration Rate (eGFR); Serum Lipid Profile (SLP). Azad Mohammed Aziz Ahmed; Department of Nursing, Darbandikhan Technical Institute, Sulaimani Polytechnic University, Sulaimani, Kurdistan Region, Iraq. (Correspondence: azad.aziz@spu.edu.iq) Amjad Mahmood Qadir; Department of General Science, College of Basic Education, University of Halabja, Halabja, Kurdistan Region, Iraq. Jamal Kareem Shakor; Department of Nursing, Darbandikhan Technical Institute, Sulaimani Polytechnic University, Sulaimani, Kurdistan Region, Iraq. Musa Zorab; Department of Physics, College of Science, University of Halabja, Kurdistan Region, Iraq. 20 Received: 21/03/2024 Accepted: 03/11/2024 Published: 30/05/2025 Copyright ©2025 The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. mailto:azad.aziz@spu.edu.iq?subject=azad.aziz@spu.edu.iq mailto:jawdat.baker@hmu.edu.krd?subject=jawdat.baker@hmu.edu.krd%20%20%20 https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2025.03 Erbil j. nurs. midwifery, Vol. 8, No. (1), May 2025 Original Article It is well-recognized that pregnancy causes significant bodily changes. In addition to raising the need for metabolic fuels for the growing fetus and the development of its supporting structures, it also alters hor- mone levels in the body, which may affect the lipid profile throughout the course of the pregnancy's many trimesters. Examina- tion of serum lipid profiles throughout the initial three months of pregnancy can po- tentially forecast the occurrence and inten- sity of pre-eclampsia [1]. The anabolic phase during early pregnancy stimulates lipogenesis and promotes the accumula- tion of fat in anticipation of the rapid growth of the fetus in late pregnancy [2]. Insulin resistance causes an increase in li- polysis, which results in a greater flow of fatty acids to the liver. This, in turn, stimu- lates the production of very low-density lipoproteins (LDLs) and leads to higher con- centrations of triglycerides (TG). Due to a reduction in the functioning of lipoprotein lipase, very low-density lipoprotein (VLDL) persists in the bloodstream for an extend- ed period, resulting in the buildup of low- density lipoprotein (LDL). Elevated levels of LDL are linked to the progression of ather- osclerosis [3]. Disordered lipid metabolism also appears to have a significant role in the development of pregnancy-induced hypertension (PIH). The correlation be- tween blood lipids and gestational pro- teinuria hypertension strongly indicates that lipid profile analysis can be used as a diagnostic tool [4]. Throughout a typical pregnancy, there is an increase in plasma triglyceride and cholesterol levels, which eventually return to normal as the preg- nancy advances. Pregnancy-induced hor- monal fluctuations impact lipid metabo- lism. Endogenous female sex hormones exert a substantial impact on serum lipids. During pregnancy, there is an elevation in hepatic lipase activity and a reduction in lipoprotein lipase activity [5]. Another study's conclusion likewise confirmed a consistent positive correlation between high levels of maternal TG and the likelihood of pre-eclampsia [6, 7]. Conversely, hyperlipidemia is considered a natural occurrence during pregnancy. Multiple studies have noticed a significant increase of 50 to 60% in cholesterol levels and a substantial increase of 100 to 200% in TG levels during uncomplicated pregnancy [8]. Furthermore, there appears to be a correlation between various pregnancy problems and the presence of extra lipid abnormalities and impaired renal function [9]. Additionally, more than half of renal function can be lost before the level of blood creatinine exceeds 120 µmol/l [10]. Pregnant women with serum creatinine levels exceeding 124 µmol/l are at a higher risk of experiencing a faster deterioration in kidney function and having a worse pregnancy outcome. When managing pregnant women with chronic kidney disease, it is important to consider various aspects to reduce the negative impact of pregnancy on the mother's kidney function and the resulting repercussions on the fetus. In addition, it is noteworthy that a significant number of individuals suffering from kidney disease and experiencing very minor impairment exhibit an unexpected rise in glomerular filtration rate (GFR) during pregnancy [11]. Prior research has indicated a potential link between lipid metabolism and renal function during pregnancy. Prior research has utilized serum creatinine as a marker for impaired RF. The categorization of renal impairment was based on the following criteria: mild, moderate, or severe [12, 13]. Finding the correlation of lipid profile with duration of pregnancy, particularly in those women who have the associated kidney problems, could help pregnancy outcome, mother’s health, and 21 Copyright ©2025 The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. INTRODUCTION https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2025.03 Erbil j. nurs. midwifery, Vol. 8, No. (1), May 2025 Original Article General Hospital. The serum was then separated from the rest of the blood by subjecting it to centrifugal force at a speed of 3000 rpm for 3 minutes and re- peating it three times. Gather specimens of females, encompassing both expectant and non-expectant individuals, from vari- ous age groups residing in urban areas. A subset of female patients has presented with comorbidities including hyperten- sion, thyroid dysfunction, diabetes melli- tus, hepatic disorders, and renal disorders. Then, with the assistance of laboratory expert staff, all necessary tests were per- formed in the laboratory department of Darbandikhan Shahid Tofiq General Hospi- tal for all pregnant women participating in our research according to our study plan. Serum Lipid Profile (SLP) The enzymatic colorimetric test method for quantifying cholesterol in human serum is conducted using the Biochemical Analyzer Biolis 30i apparatus. The hydrolysis of cholesterol esters by cholesterol esterase yields free cholesterol and fatty acids. Cholesterol undergoes oxidation, catalyzing the con- version of cholesterol to cholest-4-en-3- one and hydrogen peroxide. In the pres- ence of peroxidase, the produced hydro- gen peroxide oxidatively couples with phenol and 4-aminophenazone, forming a red quinone-imine dye. The intensity of the dye's color is directly proportional to the cholesterol concentration, measured at 500 nm. T.G. is enzymatically measured in serum via a series of coupled reactions, hydrolyzing triglycerides to produce glyc- erol. Glycerol is then oxidized by glycerol oxidase with hydrogen peroxide, a reac- tion product measured similarly to choles- terol absorbance measured at 500 nm. High-density lipoprotein is detected using the direct method without specimen pre- treatment. Initially, LDL, VLDL particles, and chylomicrons generate free cholester- ol, which, through an enzymatic reaction, fetal growth. Lipid profiles such as LDL, TG and TC could be used as indicators to as- sess a healthy pregnancy and fetal growth. This study aimed to prospectively examine the blood lipid concentration, namely lipo- protein, as well as the urea and creatinine rates, in pregnant women and compare them with those of non-pregnant women. This was case-control study conducted from August 22, 2022, until December 25, 2022. Fifty pregnant women and sixty-four non-pregnant women would enroll for ob- stetric care at the general health laborato- ry of Sulaimanyah/Darbandikhan Shahid Tofiq General Hospital. These women face various health issues during pregnancy, such as kidney function disease and elevat- ed levels of serum lipid profiles. The study aims to evaluate the correlation between blood lipid concentrations, specifically lipo- protein, as well as the rates of urea and creatinine in pregnant and non-pregnant individuals. This paper would prospectively analyze these values. Also, to identify the most influential factors among pregnancy duration in weeks, age, and BMI. Collection of Blood Samples Blood samples were tak- en from 50 pregnant women and 64 non- pregnant women in both the maternity and laboratory departments of Dar- bandikhan Shahid Tofiq General Hospital in northern Iraq. The study received approval from the ethics centre committee at Sulaimani Polytechnic University. Subse- quently, written informed consent was ob- tained from each participant. The partici- pants were provided with the opportunity to voluntarily withdraw from the research based on their preferences. Five millilitres of Venus blood were utilized for all tests. The blood was collected in a simple poly- ethylene tube and allowed to coagulate at room temperature in laboratory depart- ment of Darbandikhan Shahid Tofiq 22 Copyright ©2025The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. METHODS https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2025.03 Erbil j. nurs. midwifery, Vol. 8, No. (1), May 2025 Original Article produces hydrogen peroxide. The generat- ed peroxide undergoes a peroxidase reac- tion with N, N-bis(4-sulphobutyl)-m- toluidine-disodium (DSBmT), resulting in a colorless product. Subsequently, specific detergents solubilize HDL-cholesterol. In conjunction with the action of cholesterol oxidase (CO) and cholesterol esterase (CE), peroxidase (POD) and 4-aminoantipyrine (4 -AAP) develop a colored reaction propor- tionate to HDL-cholesterol concentration. Absorbance is measured at 600 nm. LDL- cholesterol is calculated from measured values of total cholesterol, triglycerides, and HDL-cholesterol according to the rela- tionship: [LDL-cholesterol] = [Total Chol] - [HDL-chol] - [TG]/5, where [TG]/5 esti- mates VLDL-cholesterol, with all values ex- pressed in mg/dL. Renal Function Test (RFT) Creatinine is an in vitro assay used to precisely measure the concentration of creatinine in human serum using the Bio- chemical Analyzer Biolis 30i apparatus. This enzymatic method relies on the conversion of creatinine with the assistance of creati- ninase, creatinase, and sarcosine oxidase to glycine, formaldehyde, and hydrogen peroxide. Catalyzed by peroxidase, the lib- erated hydrogen peroxide reacts with 4- aminophenazone and HTIBa to form a qui- none imine chromogen. The intensity of the color of the formed quinone imine chromogen is directly proportional to the creatinine concentration in the reaction mixture. This coloration, indicative of the creatinine concentration in the specimen, is measured at 550 nm. Blood urea is as- sessed by a kinetic method based on the specific action of urease, which hydrolyzes urea into ammonium ions and carbon diox- ide. Ammonium ions then react with chlo- ride and salicylate to form a blue-green complex. This coloration, proportional to the urea concentration in the specimen, is measured at 340 nm. Data Analysis The results of this investigation were displayed in a table using the statistical software for social sciences (SPSS) version 22.0. De- scriptive analysis was conducted on the mean and standard deviation of a bio- chemical indicator for both pregnant and non-pregnant women. A t-test was then used to see if there were any significant differences between the two groups. Pear- son correlation has been done to figure out each relationship between the dura- tion of pregnancy and para and biochemi- cal indicators in pregnant and non- pregnant women differently. A multiple linear regression model was constructed to identify the characteristics that are indica- tive of high cholesterol in pregnant wom- en. A P-value of less than 0.05 was used to determine statistical significance. And eGFR has been measured using the follow- ing formula: eGFR = 175 × (SCr) ^-1.154 × (age) ^-0.203 × (0.742). Exclusion criteria: women aged more than 50 years were ex- cluded from the analysis. Ethical Concern- ing This study has been done with the gen- eral health laboratory of Sulaimanyah/ Darbandikhan Shahid Tofiq General Hospi- tal. The authorization letter was taken from the Nursing Department, Dar- bandikhan Technical Institute, Sulaimani Polytechnic University. All patients were provided with a clear explanation of the study's objectives, and consent letters were obtained from all participants. Table 1 demonstrated that the mean age (35.54±8.7), urea (23.94±8.08), and creati- nine (0.57±0.128) were significantly higher in non-pregnant women compared with pregnant women. While the mean of cho- lesterol (182.53±36.94), HDL (54.28±11.67), and eGFR (158.34±44.40) were significantly high among pregnant women (P-value<0.05). 23 Copyright ©2025 The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. RESULT https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2025.03 Erbil j. nurs. midwifery, Vol. 8, No. (1), May 2025 Original Article 24 correlation with TSB (R = -0.405, P < 0.01) and creatinine (R = -0.967, P-value < 0.001). The study also found a significant moderate correlation of cholesterol with TG (R = 0.399, P-value < 0.01) and HDL (R = 0.385, P-value < 0.01), and serum cre- atinine had a significant correlation with the TSB (R = 0.475, P-value < 0.001). The correlation of random blood sugar was close to being significant with the TG (R = 0.285, P-value < 0.05). Table 2 indicates that LDL has a significant positive correlation with the women‘s ges- tation age (R = 0.354, P-value < 0.01), cho- lesterol (R = 0.802, P-value < 0.001), TG (R = 315, P-value <0.05.), and HDL (R = 0.454, P-value< 0.001), and a strong negative cor- relation with TSB (R = -0.431, P-value = 0.002) and creatinine (R = -0.413, P-value < 0.01). Similarly, the study found a strong correlation of eGFR with cholesterol (R = 0.305, P-value < 0.05) and LDL (R = 0.449, P -value < 0.001) and a strong negative Copyright ©2025 The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. Table 1: Mean of biochemical indicators in pregnant and non-pregnant women Variables Non-pregnant women Meant and standard deviation (N=44) Pregnant women Mean and standard deviation (N= 49) P-value Age 35.54±8.7 29.24± 6.2 < 0.001 TSB 0.66±0.22 0.59±0.21 0.148 Diabetes 108.79±30.32 110.81±31.93 0.756 Urea 23.94±8.08 18.34±5.90 < 0.001 Creatinine 0.57±0.128 0.50±0.139 0.011 Cholesterol 162.29±34.81 182.53±36.94 0.008 TG 171.13±69.76 194.46±45.32 0.057 HDL 49.25±8.97 54.28±11.67 0.023 LDL 96.45±26.25 102.14±30.93 0.344 eGFR 127.48±32.33 158.34±44.40 < 0.001 Table 2: Correlation of biochemical indicators and gestational age in pregnant women Control Variables Age & Para Age of pregnancy in Weeks TSB Diabetes Urea Creati- nine Choles- terol TG HDL LDL TSB -0.045 P-value 0.762 Diabetes 0.237 0.180 P-value 0.105 0.221 Urea -0.043 -0.031 -0.084 P-value 0.771 0.836 0.569 Creatinine -0.242 0.475 -0.155 0.196 P-value 0.097 0.001 0.293 0.182 Total Cholesterol 0.279 -0.254 0.217 -0.040 -0.265 . P-value 0.055 0.081 0.138 0.789 0.069 . TG 0.173 -0.052 0.284 -0.235 -0.020 0.399 P-value 0.239 0.728 0.050 0.107 0.894 0.005 . HDL 0.239 -0.250 -0.095 0.186 -0.186 0.385 -0.072 . P-value 0.102 0.086 0.523 0.206 0.206 0.007 0.626 . LDL 0.354 -0.431 0.123 -0.251 -0.413 0.802 0.315 0.454 P-value 0.014 0.002 0.406 0.085 0.004 0.000 0.029 0.001 . eGFR 0.216 -0.405 0.138 -0.257 -0.967 0.305 0.003 0.166 0.449 P-value 0.140 0.004 0.350 0.078 < 0.001 0.035 0.981 0.261 < 0.001 https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2025.03 Erbil j. nurs. midwifery, Vol. 8, No. (1), May 2025 Original Article Serum creatinine also has a significant pos- itive correlation with urea level (R = 0.300, P-value < 0.05) and a negative correlation with random blood sugar (R = -0.394, P- value < 0.001). Cholesterol also has a sig- nificant moderate correlation with TG (R = 0.364, P-value < 0.01). Creatinine, Age, HDL, and eGFR. The re- gression model has shown a significant co- efficient of LDL and urea with cholesterol. The model shows that urea and LDL indi- cate 1.398 % and 0.913 % variances in cho- lesterol levels, respectively. 25 Table 3 shows the correlation coefficient among biochemical indicators and gesta- tional age of pregnancy. The study has shown a moderate positive correlation of eGFR with random blood sugar (R = 0.434, P-value < 0.001) and a negative strong to moderate correlation with urea (R = - 0.365, P-value < 0.01) and creatinine (R = - 0.916, P-value < 0.001). Table 4 demonstrate a linear regression model of multiple variables with the cho- lesterol level in pregnant women. The lin- ear regression model has explored a 70 % variance in cholesterol level, significantly explained by Para, LDL, Diabetes, BMI, Urea, and age of pregnancy in weeks, TG, Copyright ©2025 The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. Table 3: Correlation of biochemical indicators and gestational age in non-pregnant women. Control for age. Non-pregnancy women Diabe- tes Urea Creati- nine Choles- terol TG HDL LDL Egfr TSB 0.073 0.066 -0.115 -0.083 -0.001 -0.183 -0.077 0.177 P-value 0.570 0.609 0.370 0.518 0.994 0.151 0.551 0.165 Diabetes -0.145 -0.394 -0.105 0.022 -0.132 -0.034 0.434 P-value 0.256 0.001 0.414 0.862 0.304 0.792 0.000 Urea 0.300 0.069 -0.086 -0.050 0.107 -0.365 P-value 0.017 0.592 0.503 0.695 0.402 0.003 Creatinine -0.076 -0.065 -0.121 -0.167 -0.916 P-value 0.554 0.610 0.345 0.190 0.000 Cholesterol 0.364 0.180 0.715 0.062 P-value 0.003 0.158 0.000 0.627 TG -0.251 0.126 0.008 P-value 0.047 0.324 0.952 HDL 0.053 0.118 P-value 0.679 0.355 LDL 0.132 P-value 0.302 https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2025.03 Erbil j. nurs. midwifery, Vol. 8, No. (1), May 2025 Original Article correlation with protein excretion products such as TSB and creatinine. Gestational age has more indicated the lipid profile. This finding has been proven by many other studies. TC, TG, and LDL have been increas- ing with gestational age [16, 17]. A study has confirmed that there is an association between lipid profile and uric acid in preeclampsia and dyslipidemia and raised uric acid levels are symptoms of preeclampsia in nullipara pregnant women in their third trimester [18]. This study could not find a significant association be- tween urea and lipid profiles in pregnant women. Among pregnant women, the cur- rent study has indicated that LDL has a sig- nificant positive correlation with the wom- an’s gestation period, cholesterol, TG, and HDL, and a strong negative correlation with TSB, and creatinine. The study also found a significant moderate correlation between cholesterol and TG and HDL, and serum creatinine had a significant The objective of this study was to deter- mine the metabolic differences in lipid profile and kidney function between preg- nant and non-pregnant individuals. Preg- nancy status was known by a high level of lipid profile and a decreased level of urea and creatinine. The latest research has shown that the mean urea and creatinine levels were significantly decreased in preg- nant women, whereas the average levels of cholesterol, HDL, and eGFR were ob- served to be significantly high. Another study has confirmed that TC, TG, LDL-C, HDL-C, and eGFR all increase significantly during pregnancy. Pregnant women exhib- ited decreased levels of urea, creatinine, and uric acid. [14, 15]. Lower levels of urea, creatinine, and uric acid in pregnan- cy are mostly related to high renal blood flow and GFR in pregnant women [15]. Compared to non-pregnant status, in preg- nancy status, the metabolism of biochemi- cal profiles such as LDL and TC has a high 26 Copyright ©2025 The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. Table 4: Coefficient linear regression of cholesterol Predictor variables Unstandardized Co- efficients Standard- ized Coefficients t-value P-value 95.0% Confidence Interval for B B Std. Error Beta Lower Bound Upper Bound (Constant) -125.245 107.770 -1.162 0.252 -343.415 92.924 TG 0.163 0.084 0.202 1.954 0.058 -0.006 0.332 HDL 0.138 0.336 0.043 0.409 0.685 -0.543 0.818 LDL 0.913 0.148 0.764 6.178 0.000 0.614 1.212 Diabetes 0.130 0.108 0.113 1.211 0.233 -0.087 0.348 Urea 1.398 0.615 0.223 2.276 0.029 0.154 2.642 Creatinine 124.263 92.882 0.470 1.338 0.189 -63.766 312.293 eGFR 0.377 0.300 0.452 1.257 0.216 -0.230 0.985 Age 0.414 0.576 0.080 0.719 0.477 -0.752 1.580 Gestational period in Weeks -0.124 0.306 -0.038 -0.405 0.688 -0.744 0.496 BMI 0.217 0.614 0.031 0.353 0.726 -1.027 1.460 Para -1.298 3.203 -0.042 -0.405 0.688 -7.783 5.187 Discussion https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2025.03 Erbil j. nurs. midwifery, Vol. 8, No. (1), May 2025 Original Article variables. The linear regression model has explored a 70 % variance in cholesterol level, which is significantly explained by Para, LDL, Diabetes, BMI, Urea, Age of Pregnancy in Weeks, TG, Creatinine, Age, HDL, and eGFR. The regression model has shown a significant coefficient of LDL and urea with cholesterol [24]. The model has shown that urea and LDL indicate a 1.398% and 0.913% variance in cholesterol levels, respectively. A lipid profile can help predict the risk of gestational diabetes [25, 26], while the current study could not find a significant correlation between lipid profile and random blood sugar [27]. To sum up, this study highlights notable metabolic disparities between pregnant and non-pregnant women, namely in terms of lipid profiles and kidney function. In pregnant women, LDL shows significant positive correlations with gestation age, cholesterol, TG, and HDL, alongside strong negative correlations with TSB and creati- nine. Moreover, eGFR demonstrates strong positive associations with cholester- ol and LDL and negative correlations with TSB and creatinine, while moderate corre- lations exist between cholesterol and TG as well as HDL. Serum creatinine also ex- hibits a significant correlation with TSB. Conversely, in non-pregnant individuals, eGFR moderately correlates with random blood sugar but strongly negatively corre- lates with urea and creatinine. Serum cre- atinine shows a significant positive correla- tion with urea and a negative correlation with random blood sugar, while cholester- ol displays a significant moderate correla- tion with TG. These findings emphasize the complexity of biomarker interactions and their implications for health in diverse physiological contexts. correlation with the TSB. Other studies have found that serum levels of uric acid, creatinine, and blood urea indicate the pre -eclamptic status of pregnant women [19]. In this study, urea and creatinine were sig- nificantly decreased in pregnant women [20], and creatinine and TSB were nega- tively correlated with LDL [21]. Among non -pregnant women, TSB and serum creati- nine did not have a significant correlation with LDL [22]. Decreased levels of TSB and serum creatinine in pregnant women are related to kidney function during pregnan- cy, which leads to an increase in eGFR and the excretion of proteins such as creati- nine and TSB. In addition, during pregnan- cy, physiological adaptations occur to sup- port fetal growth and development; these adaptations can affect renal function and lipid metabolism, leading to changes in the correlation between eGFR and cholester- ol/LDL [23].Similarly, the study found a strong positive correlation between eGFR and cholesterol and LDL, but this correla- tion was not significant among non- pregnant women. Among non-pregnant women, this study has shown a moderate- ly positive correlation of eGFR with ran- dom blood sugar and a strong to moder- ately negative correlation with urea. This correlation was not found among preg- nant women. Normally, during pregnancy, eGFR increases by 50%, which also leads to a substantial decrease in serum creati- nine, urea, and uric acid values [20]. Over- all, the combination of increased renal blood flow, hormonal influences, and changes in lipid metabolism, physiological adaptations, and gestational hypertensive disorders can lead to a strong positive cor- relation between eGFR and cholesterol/ LDL during pregnancy, whereas this corre- lation may not be as significant among non -pregnant women due to differences in hormonal and physiological status. A high cholesterol rate is indicated by several 27 Copyright ©2025 The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. CONCLUSION https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2025.03 Erbil j. nurs. midwifery, Vol. 8, No. (1), May 2025 Original Article [4] Devi, S.A., Study of Serum Lipid Profile in Second Trimester as a Predictor for Pregnan- cy Induced Hypertension in Rajarajeswari Medical College and Hospital. 2019, Master Thesis Rajiv Gandhi University of Health Sci- ences (India). [5] Casado, M.E., L. Huerta, A. Marcos-Díaz, A.I. Ortiz, F.B. 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This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. https://creativecommons.org/licenses/by-nc-sa/4.0/