1964-LB: Association between Fasting Venous Lactate Level and Development of Preeclampsia in Pregnant Individuals with Gestational Glucose Intolerance

Introduction & Objective: Pre-eclampsia (PE) is a hypertensive disorder in pregnancy thought to result from abnormal vascular placentation that is associated with metabolic dysfunction. Blood lactate is also associated with metabolic dysfunction. Few studies have explored if lactate is associated with PE. The purpose of this pilot prospective cohort study was to determine if blood lactate is higher among patients with GGI (i.e. an abnormal screening glucose tolerance test (GTT) between 24-28 weeks gestational age) that subsequently developed PE.

Methods: Participants were included if they had GGI and fasting lactate collected during standard 100g GTT. Fasting venous blood was collected to determine lactate, insulin, and glucose and HOMA-IR was calculated. Chi-square, t-test, and Mann-Whitney U analyses were performed to assess differences between groups (PE vs no PE) and binary logistic regression analysis assessed for differences in lactate, to control for pre-pregnancy BMI.

Results: A total of 106 individuals were included in our analysis. Of these, 14 (13%) developed PE and 92 (87%) did not. There were no differences in fasting glucose, insulin, or HOMA-IR between groups. Median fasting lactate level was higher among those who developed PE (1.05mmol/L IQR 0.20 vs 0.9 mmol/L IQR 0.18, p=0.053) and was a significant predictor of PE after controlling for pre-pregnancy BMI (p=0.047).

Conclusion: Our study highlights evidence that fasting venous lactate levels are elevated in pregnant persons with GGI who subsequently develop PE in pregnancy. Future studies should attempt to identify why individuals who develop PE with GGI have increased fasting venous lactate levels.