EVALUATION OF MATERNAL TRIGLYCERIDES AS A PREDICTING FACTOR FOR PREECLAMPSIA IN A TERTIARY CARE CENTRE

Abstract

Background: Preeclampsia is a pregnancy-specific multisystem hypertensive disorder and remains a major cause of maternal and perinatal morbidity and mortality worldwide. Increasing evidence suggests that maternal dyslipidaemia, particularly elevated serum triglyceride levels, contributes to endothelial dysfunction and abnormal placentation, predisposing women to the development of preeclampsia. Identification of a simple and inexpensive biomarker for early prediction may facilitate timely antenatal surveillance and improve pregnancy outcomes. Materials and Methods: This prospective observational study was conducted in the Department of Obstetrics and Gynaecology, Sree Balaji Medical College and Hospital, Chennai, over a period of 18 months. A total of 100 pregnant women with singleton pregnancies between 13 and 20 weeks of gestation were enrolled using consecutive sampling. After obtaining informed consent, fasting maternal serum triglyceride levels were estimated using the enzymatic Glycerol-3 Phosphate Oxidase–Phenol Aminophenazone (GPO-PAP) method. Participants were followed until delivery for the occurrence of preeclampsia. Data were analysed using appropriate statistical tests, and the diagnostic performance of serum triglycerides was assessed by calculating sensitivity, specificity, positive predictive value, negative predictive value, overall accuracy, and receiver operating characteristic analysis. Results: The mean maternal age was 25.8 ± 4.2 years, and the mean gestational age at enrolment was 16.2 ± 2.1 weeks. Elevated serum triglyceride levels (≥150 mg/dL) were observed in 40.0% of participants. Overall, 22.0% of women developed preeclampsia during follow-up. The incidence of preeclampsia was significantly higher among women with elevated triglyceride levels (40.0%) compared with those having triglyceride levels <150 mg/dL (10.0%). Women with elevated triglycerides also had significantly higher systolic (122 ± 10 vs. 116 ± 9 mmHg; p=0.010) and diastolic blood pressure (78 ± 6 vs. 72 ± 5 mmHg; p=0.020). Maternal serum triglyceride estimation demonstrated a sensitivity of 72.7%, specificity of 69.2%, positive predictive value of 40.0%, negative predictive value of 90.0%, and an overall diagnostic accuracy of 70.0% for predicting preeclampsia. Conclusion: Elevated maternal serum triglyceride levels during the early second trimester were significantly associated with the subsequent development of preeclampsia. Maternal serum triglyceride estimation demonstrated satisfactory diagnostic performance and a high negative predictive value, indicating its potential utility as a simple, inexpensive, and readily available adjunctive screening tool for early risk stratification during routine antenatal care. Larger multicentric studies are warranted to validate these findings and establish standardized cut-off values for clinical application.