Quick Take: Metabolic syndrome in pregnancy and risk for adverse pregnancy outcomes: A prospective cohort of nulliparous women

While obesity has been shown to increase the risk of developing gestational diabetes mellitus (GDM) and preeclampsia (PE) in pregnancy, the association between metabolic syndrome and adverse pregnancy outcomes has not been investigated. In this multicenter prospective cohort study, 5,530 nulliparous women with singleton pregnancies recruited between November 2004 and February 2011 were followed up to assess the association between metabolic syndrome (MetS) and pregnancy outcomes. MetS was defined using the International Diabetes Federation (IDF) MetS criteria, assessed at 15  1 weeks’ gestation. Variables included in the IDF MetS criteria include increased waist circumference, increased triglycerides, reduced high density-lipoprotein C (HDL-C), increased blood pressure, and increased fasting blood glucose. Pregnancy outcomes included preeclampsia, gestational diabetes mellitus (GDM), spontaneous preterm birth (sPTB), large for gestational age (LGA) and small for gestational age (SGA). Researchers found that 12.3% of women had MetS.  Women with MetS had an increased risk of preeclampsia by a factor of 1.63 (95% CI 1.23 to 2.15) and GDM by a factor of 3.71 (95% CI 2.42 to 5.67). A diagnosis of MetS was not associated with an increased risk of sPTB, LGA, or SGA. It should be noted that this study has limited generalizability as 90% of study participants were white. This study also did not compare the impact of individual metabolic components to that impact of MetS on pregnancy outcomes. Overall, results from this study indicate that women with metabolic syndrome are more likely to develop preeclampsia and GDM compared to women without MetS.

Click to read the study in PLOS Medicine

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