Exploring cardiometabolic markers in adverse pregnancy outcomes: insights from the GROWell study

Abstract Women with pre-pregnancy overweight or obesity are at increased risk of adverse pregnancy outcomes (APOs) and postpartum weight retention (PPWR). We examined which lipid classes during pregnancy and at 3 months postpartum were associated with APOs or PPWR at 6 months using a subsample from a clinical trial. Data were collected via questionnaires, electronic health records, and participant-collected dried blood spots at three timepoints. Lipidomic profiles were measured at all three time points in 49 participants. Using weighted-lipid correlation network analysis, we identified triglyceride (TG)-rich lipid signatures associated with APOs or PPWR at 6 months, with additional lipid-level analyses supporting TG involvement. In early pregnancy, two TG networks and several individual TGs were consistently associated with APOs. For PPWR at 6 months, one TG network at 36-38 weeks and three TG networks at 3 months postpartum were found to be associated with the outcome. These findings highlight TG lipids’ potential role in pregnancy outcomes and the need for larger studies to confirm TG-based lipidomic biomarkers for early risk identification to improve maternal and fetal health.