Hypertriglyceridemia: Their association with hypertensive disorders, fetal macrosomia and postpartum reclassification in patients with gestational diabetes.

Abstract

INTRODUCTION: Gestational diabetes mellitus (GDM) is associated with adverse perinatal outcomes, including fetal macrosomia and hypertensive disorders. Alterations in lipid metabolism, particularly hypertriglyceridemia, have been proposed as potential predictors; however, their clinical utility remains uncertain. Objectives: This study aimed to evaluate the association between third-trimester triglyceride (TG) levels and hypertensive disorders, large-for-gestational-age (LGA) newborns, macrosomia, and postpartum metabolic reclassification (PPR) in women with GDM. MATERIALS AND METHODS: A retrospective cohort study was conducted including 563 patients with GDM and available third-trimester TG measurements. Maternal characteristics and perinatal outcomes were analyzed. TG levels were categorized using a conventional cutoff (<150 mg/dL), and receiver operating characteristic (ROC) curves were constructed to assess diagnostic performance. RESULTS: Hypertriglyceridemia (≥150 mg/dL) was present in 92.2% of the population. The incidence of macrosomia, LGA, and hypertensive disorders was 14.5%, 11.9%, and 10.7%, respectively. No statistically significant differences were observed between normal and elevated TG levels for any outcome. ROC curve analyses demonstrated poor discriminative ability (AUC ≈ 0.5), with low sensitivity and specificity. TG levels were also not associated with PPR (256 vs. 254 mg/dL). CONCLUSIONS: Third-trimester TG levels did not demonstrate clinical utility as predictive biomarkers in this cohort. Glycemic control remains the cornerstone of GDM management, and trimester-specific lipid reference ranges are needed before incorporating lipid monitoring into routine practice.