Second-trimester maternal lipid profiles predict pregnancy complications in an age-dependent manner

Our objective was to investigate the combinatorial effect of maternal age and second-trimester maternal lipid profiles for pregnancy complications.

With 1:4 matching, this retrospective study selected 499 advanced maternal age women and 1996 younger controls. Logistic regression analysis was used to estimate the correlation between second-trimester lipid profiles [total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C)] and pregnancy complications [gestational diabetes mellitus (GDM), pregnancy-induced hypertension syndrome (PIH), preterm labor (PTL), and macrosomia]. Optimal cutoff points were determined by ROC curve analysis.

In women aged 20-34 years, TG are a risk factor for PIH (OR 1.54, 95% CI 1.16-2.04) and PTL (OR 1.34, 95% CI 1.04-1.72). LDL-C was positively associated with macrosomia (OR 1.25, 95% CI 1.04-1.50), while HDL-C was negatively associated with PIH (OR 0.45, 95% CI 0.21-0.93). The optimal cutoff points for TG predicting PIH and PTL were separately ≥ 2.135 and 2.305 mmol/L. The optimal cutoff point for HDL-C identifying PIH was ≤ 1.995 mmol/L and for LDL-C identifying macrosomia was ≥ 3.425 mmol/L. As for advanced maternal age, only TG was an independent risk factor for PIH (OR 1.60, 95% CI 1.01-2.54), and its optimal cutoff point was ≥ 2.375 mmol/L.

Second-trimester lipid profiles might predict pregnancy complications varied by maternal age. This suggested that individualized prenatal care strategies should be established for women with advanced and normal maternal age to prevent pregnancy complications.