First-trimester dyslipidemia in pregnant women with subclinical hypothyroidism is associated with an increased risk of adverse pregnancy outcomes, according to a recent cohort study.
Subclinical hypothyroidism is associated with dyslipidemia and may have adverse pregnancy outcomes. This thyroid disorder is common during pregnancy, increasing the risk for small for gestational age infants, preterm birth, and preeclampsia. There is, however, uncertainty regarding the outcomes of dyslipidemia in women with subclinical hypothyroidism in pregnancy.
This cohort study assessed the relationship between first-trimester dyslipidemia and adverse clinical outcomes in pregnant women with subclinical hypothyroidism. The findings are published in the journal Lipids in Health and Disease.
Baseline Characteristics
A total of 26776 women, all patients at a hospital in Beijing, China, were included in the analysis, of which 952 pregnant women had subclinical hypothyroidism. Of these women, the majority (80.88%) had dyslipidemia, and the remainder presented without dyslipidemia. Women who presented with dyslipidemia were comparatively obese, had a higher pre-body mass index (BMI), or were older. In women with subclinical hypothyroidism who had dyslipidemia, there was a comparatively higher incidence of low birth weight, gestational hypertension, and eclampsia or preeclampsia in the first trimester.
Dyslipidemia and Adverse Pregnancy Outcomes
Women with subclinical hypothyroidism who presented with dyslipidemia exhibited a significantly increased risk of low birth weight, gestational hypertension, gestational diabetes mellitus, and eclampsia/preeclampsia, which persisted after adjusting for the use of levothyroxine.
Dyslipidemia Types and Adverse Pregnancy Outcomes
Regarding the types of dyslipidemia, elevated total cholesterol was associated with an increased risk for preeclampsia/eclampsia, and elevated triglycerides was associated with increased risks for gestational hypertension, low birth weight, and gestational diabetes mellitus. Dyslipidemia with increased LDL-C was correlated with increased gestational diabetes mellitus and preeclampsia/eclampsia incidence. Decreased HDL-C dyslipidemia was correlated with low birth weight.
Predictive Value of Dyslipidemia Data in Adverse Pregnancy Outcomes
The study demonstrated the predictive values of pre-BMI, total cholesterol, triglycerides, and LDL-C levels during pregnancy in women with subclinical hypothyroidism for adverse pregnancy outcomes including gestational hypertension, gestational diabetes mellitus, and preeclampsia/eclampsia. The combination of pre-BMI, thyroid-stimulating hormone, LDL-C, total cholesterol, triglycerides, and TPOAb had better predictive value for gestational hypertension. The combination of pre-BMI, thyroid-stimulating hormone, LDL-C, total cholesterol, and triglycerides had a better predictive value for preeclampsia/eclampsia.
Source:
Wang, X., Zhang, E., Tian, Z., Zhao, R., Huang, K., Gao, S., Su, S., Xie, S., Liu, J., Luan, Y., Zhang, Y., Zhang, Z., Yan, Y., Yue, W., Yin, C. H., & Liu, R. (2024). The association between dyslipidaemia in the first trimester and adverse pregnancy outcomes in pregnant women with subclinical hypothyroidism: a cohort study. Lipids in Health and Disease, 23(1). https://doi.org/10.1186/s12944-023-01998-7
