Objective: A high plasma triglyceride (TG) concentration during pregnancy is associated with adverse pregnancy outcomes. It is important to define a cutoff to initiate interventions. Since it remains unknown if there is a threshold, our aim is to explore the cutoff values of plasma TG in the first and second trimesters.

Research Design and Methods: A prospective cohort study was conducted which included 837 pregnant women. Fasting plasma TG were measured in the first and second trimesters and were divided into seven categories according to its percentile, respectively. The presence of adverse pregnancy outcome was defined if anyone of the following condition developed, including gestational diabetes mellitus (GDM), pregnancy-induced hypertension (PIH), preeclampsia, preterm delivery, and large for gestational age (LGA).

Results: For the relationship between plasma TG and adverse pregnancy outcomes, there was a threshold between the highest and the second-highest categories in the first and second trimesters. The adjusted odds ratios (95% confidence interval) of adverse pregnancy outcomes for the 7 categories were 1, 0.75 (0.28-1.96), 1.46 (0.59-3.59), 1.83 (0.74-4.51), 1.19 (0.48-2.95), 1.11 (0.43-2.86), and 3.34 (1.35-8.25) for plasma TG in the first trimester, and 1, 1.81 (0.82-4.02), 2.07 (0.94-4.57), 2.50 (1.15-5.46), 2.19 (1.00-4.80), 2.14 (0.97-4.71), and 3.53 (1.62-7.69) for plasma TG in the second trimester. Using the threshold as the cutoff values, women with high plasma TG concentrations in the first trimester or second trimesters were associated with increased risk for adverse pregnancy outcomes (≥150 mg/dL in the first trimester, OR 2.75, 95% CI 1.45-5.24, p = 0.002; ≥246 mg/dL in the second trimester, OR 1.78, 95% CI 1.11-2.85, p = 0.017).

Conclusions: There are inflection points for plasma TG in the first and second trimesters. The risk of adverse pregnancy outcomes increase significantly if plasma TG exceed this point, which may also be a cutoff to initiate interventions in the future.

Disclosure

S. Chen: None. H. Li: None.

© 2019 by the American Diabetes Association.
2019
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