Trimester-Specific Serum Lipid Profiles in Gestational Diabetes Mellitus: A Systematic Review, Meta-Analysis, and...

Background and Objectives: Gestational diabetes mellitus (GDM) is a major public health concern associated with adverse maternal and neonatal outcomes. It was found that even physiological pregnancy is followed by a significant shift in serum lipid profile, and even more pronounced in GDM pregnancies. We aimed to comprehensively assess lipid parameters among pregnant women with and without GDM. Materials and Methods: A systematic review, covering PubMed, WoS, and SCOPUS until 23 July 2024, with meta-analysis and meta-regression, was conducted, comprising studies measuring TG, TC, LDL-C, HDL-C, VLDL-C, and TG/HDL ratio in pregnant women diagnosed with GDM, and those with normal glucose tolerance. The overall effect size measure was the SMD. NOS and JADAD scales were used for quality assessment, I² statistics for heterogeneity evaluation, and funnel plots for publication bias inspection. Results: A total of 457 studies were included in the qualitative analysis, and 74, 277, and 122 studies were included in the quantitative analysis for the 1st 2nd, and 3rd trimester, respectively. TG and TG/HDL levels were significantly elevated in all three trimesters (TG: SMD = 0.61, 0.57, and 0.48, p < 0.001 for all, and TG/HDL: SMD = 0.44, 0.66, and 0.49; p < 0.001 for all), while TC and LDL-C levels showed significant increases in the 1st and 2nd trimesters (TC: SMD = 0.38, 0.27, p < 0.001 for both, LDL-C: SMD = 0.33, 0.20, p < 0.001 for both), in pregnant women with GDM compared to those without the condition. Conclusions: GDM is associated with significant lipid abnormalities, particularly elevated TG and decreased HDL-C levels. These lipid changes are most pronounced in the first and second trimesters, highlighting the importance of early detection and management.