New Research Links Early Pregnancy Blood Markers to Higher Risk of Complications in Diabetic Mothers
A recent study published in BMC Pregnancy and Childbirth reveals a significant association between first-trimester atherogenic index of plasma (AIP) and triglyceride-glucose (TG/G) indices and adverse pregnancy outcomes in women with pregestational diabetes mellitus. Researchers found elevated levels of these markers-indicators of insulin resistance and lipid metabolism-correlated with increased rates of preeclampsia, preterm birth, and large for gestational age (LGA) infants.
The findings, stemming from a prospective cohort study, underscore the critical need for early risk assessment and potentially targeted interventions for diabetic women planning or experiencing pregnancy. Approximately 1% of pregnancies are elaborate by pregestational diabetes, a condition placing both mother and child at heightened risk. Identifying readily measurable biomarkers like AIP and TG/G during the first trimester could allow clinicians to proactively manage pregnancies, potentially mitigating severe complications and improving maternal and neonatal health.
The study involved a cohort of pregnant women with pregestational diabetes. Researchers assessed first-trimester AIP and TG/G indices and tracked pregnancy outcomes. Results demonstrated that higher AIP and TG/G values were significantly associated with a greater likelihood of developing preeclampsia. Specifically, women in the highest quartiles of AIP and TG/G exhibited substantially elevated odds ratios for preeclampsia compared to those in the lowest quartiles.
Furthermore, the research indicated a link between elevated AIP and TG/G levels and an increased risk of preterm birth. Women with higher indices were more likely to deliver before 37 weeks of gestation. The study also found a positive correlation between these markers and the birth of LGA infants-babies weighing over 4000 grams at birth-which can lead to delivery complications and long-term health issues for both mother and child.
Researchers, including W. Zhang, X. Yuan, R. Yang, J.Huang, H. Pang, Y. Lu, Y. Zhang, T. Chen, Z. Wang, and G.Li, emphasize the potential for these indices to serve as valuable tools in clinical practise. A separate 2025 study published in J Endocrinol Invest (W,Yuan X,Yang R,Huang J,Pang H,Lu Y,Zhang Y,Chen T,Wang Z,Li G. Assessment of first-trimester insulin resistance indices for gestational diabetes mellitus: a prospective cohort study. 2025;48(9):2167-76) similarly highlighted the importance of first-trimester insulin resistance assessment. Further research is warranted to determine the optimal cut-off values for these indices and to evaluate the effectiveness of interventions aimed at reducing AIP and TG/G levels in high-risk pregnancies.
Related research, such as a 2023 study in Acta Obstet Gynecol Scand (Skytte HN, Christensen JJ, Gunnes N, Holven KB, Lekva T, Henriksen T, Michelsen TM, Roland MCP. Metabolic profiling of pregnancies complicated by preeclampsia: A longitudinal study. 2023;102(3):334-43), supports the broader concept of metabolic profiling as a means of predicting and managing pregnancy complications. These findings collectively point towards a growing understanding of the metabolic factors influencing pregnancy outcomes and the potential for personalized approaches to prenatal care.