Prevalence, Adverse Neonatal Outcomes, and Factors Associated With Maternal Dyslipidemia Among Women Admitted in the Postnatal Unit at Kayunga Regional Referral Hospital, Uganda

Introduction: Maternal dyslipidemia is an emerging public health concern associated with adverse pregnancy and neonatal outcomes, including preterm birth, macrosomia, and neonatal complications. Despite extensive global research, there is limited data from Uganda regarding the burden, determinants, and neonatal implications of maternal lipid abnormalities. Methods A cross-sectional study was conducted among 376 postpartum women at Kayunga Regional Referral Hospital from May to September 2025. Data on socio-demographic, obstetric, medical, and lifestyle characteristics were collected using structured questionnaires. Blood samples were analyzed for lipid profiles including total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG). Neonatal outcomes were abstracted from clinical records. Bivariate and multivariate logistic regression analyses were performed to identify factors independently associated with maternal dyslipidaemia, with significance considered at p < 0.05. Results The prevalence of maternal dyslipidemia was 58.2% (219/376; 95% CI: 53.2%-63.2%). The most common lipid abnormality was low HDL-C (< 40/50 mg/dL), observed in 71.5% (269/376) of mothers, followed by elevated LDL-C (≥ 130 mg/dL) in 41.2% (155/376), hypertriglyceridemia (TG ≥ 150 mg/dL) in 39.9% (150/376), and elevated total cholesterol (TC ≥ 200 mg/dL) in 21.8% (82/376). Maternal dyslipidemia was significantly associated with preterm birth (χ² = 9.15, p = 0.0025), neonatal hypoglycemia (p = 0.018), and neonatal jaundice (χ² = 17.33, p < 0.001). Multivariate analysis revealed that pre-pregnancy obesity (AOR = 2.17, 95% CI: 1.73–6.31, p = 0.04), pre-eclampsia (AOR = 2.07, 95% CI: 1.67–6.43, p = 0.02), current smoking (AOR = 2.36, 95% CI: 1.93–4.62, p = 0.01), and physical inactivity (AOR = 2.74, 95% CI: 1.63–7.48, p = 0.04) were independent predictors of maternal dyslipidemia. Conclusion Maternal dyslipidemia is highly prevalent among postpartum women, with low HDL-C being the most frequent lipid abnormality. There is urgent need for routine lipid screening during antenatal care and implementation of lifestyle interventions to mitigate dyslipidemia and improve maternal and neonatal health outcomes.