Prediction of adverse pregnancy outcomes by first-trimester components of metabolic syndrome: a prospective longitudinal study.

Abstract

This study aimed to identify the optimal cutoff values of each component of metabolic syndrome (MetS) in the first trimester of pregnancy for predicting adverse pregnancy outcomes. A total of 1076 pregnant women in the first trimester of gestation were recruited in this prospective longitudinal cohort study. Specifically, 993 pregnant women at 11-13weeks of gestation who were followed up until the end of pregnancy were included in the final analysis. The cutoff values of each component of MetS in the occurrence of adverse pregnancy outcomes including gestational diabetes (GDM), gestational hypertensive disorders, and preterm birth were obtained via receiver operating characteristic (ROC) curve analysis using the Youden's index. Among the 993 pregnant women studied, the significant associations between the first trimester MetS components and adverse pregnancy outcomes were as follows: triglyceride (TG) and body mass index (BMI) with preterm birth; mean arterial pressure (MAP), TG, and high-density lipoprotein cholesterol (HDL-C) with gestational hypertensive disorders; BMI, fasting plasma glucose (FPG), and TG with GDM (all p values < 0.05). The cutoff point values for the above-mentioned MetS components were: TG > 138mg/dl and BMI < 21kg/m2 for the occurrence of preterm birth; TG > 148mg/dL, MAP > 84, and HDL-C < 84mg/dl for gestational hypertensive disorders; BMI > 25kg/m2, FPG > 84mg/dl, and TG > 161mg/dl for GDM. The study findings imply the importance of early management of metabolic syndrome in pregnancy to improve maternal-fetal outcomes.