Associations between triglyceride-glucose index in the early trimester of pregnancy and adverse pregnancy outcomes.

Objective: Adverse pregnancy outcomes seriously affect the health of pregnant women and fetuses. However, no typical symptoms occur in the early trimester of pregnancy. The present study aimed to evaluate the predictive efficacy of the triglyceride-glucose (TyG) index in the early trimester for adverse pregnancy outcomes.

Methods: A total of 2,847 singleton pregnant women without preconception diabetes and hypertension were included. The multivariate logistic regression model was used to explore the relationship between the TyG index and pregnancy adverse outcomes.

Results: TyG index in the early trimester of pregnancy was an independent risk factor for gestational diabetes mellitus (GDM) (OR = 2.16, 95%CI 1.63-2.87, P < 0.001) and gestational hypertension (GH) (OR = 1.95, 95%CI 1.14-3.33, P < 0.05). The optimal cut-off point of the TyG index for GDM was 8.345 (sensitivity 53.33%, specificity 70.19%), and the area under the curve (AUC) was 0.630 (95% CI 0.600-0.660, P < 0.001). The optimal cut-off point of the TyG index for predicting GH was 8.425 (sensitivity 46.67%, specificity 76.19%), and the AUC was 0.622 (95%CI 0.578-0.665, P < 0.001). The restricted cubic spline (RCS) curve showed that there was a significant linear association between the early trimester TyG index and GDM or GH when it was > 8.167.

Conclusion: The first-trimester TyG index is closely associated with the development of GDM and GH among pregnant women. An elevated TyG index in early trimester pregnancy may help predict the risk of GDM and GH, which provides an effective marker for us to prevent and detect adverse pregnancy outcomes in the early stage.