We have previously shown that maternal metabolic syndrome (MetS) in early pregnancy increased risk for GDM (4-fold) and preeclampsia (2-fold) in the international SCOPE Study. In separate analyses we have also shown increased folate status and vitamin D deficiency increased risk for GDM. Here we aimed to investigate the combination of these factors and placental hormone secretion in the STOP Study. Maternal MetS was assessed using IDF criteria at 11-16 weeks’ gestation. Circulating red cell folate, serum B12, homocysteine, vitamin D, PRL, hPL and GH2 were also quantified at this time. Logistic regression models were adjusted for maternal BMI, age and socioeconomic index. Splines were used to model non-linearity of continuous variables to assess interactions in pregnancy outcomes.
Data were available for 1208 women of whom 112 (9%) had MetS. Women with MetS were significantly more likely to develop GDM (38.2% vs 13.5%), preeclampsia (18.5% vs 8.9%) and gestational hypertension (14.4% vs 6.1%) than those without MetS. SGA and spontaneous preterm birth were similar between the two groups.
In women with MetS, serum vitamin D was significantly lower (p<0.005) with more women deficient or insufficient in this secosteroid hormone. Serum folate was higher while red cell folate (RCF) was not different in women with MetS but the ratio of RCF to vitamin D was higher in women with MetS (p<0.001). hPL was also significantly lower in women with MetS than those without it (p<0.0008). Both PRL and GH2 were lower in women with MetS but these were not significant.
MetS, independent of maternal BMI, appears to have important impacts on pregnancy outcomes and their mediators. MetS is also a risk factor for long term cardiometabolic diseases. Therefore, reducing its incidence and severity is essential for pregnancy planning and future health.