Exploring cardiometabolic markers in adverse pregnancy outcomes: insights from the GROWell study.

Women with pre-pregnancy overweight or obesity are at increased risk of adverse pregnancy outcomes (APOs) and postpartum weight retention (PPWR). We examined which lipid classes were associated with APO and PPWR during pregnancy and postpartum using a subsample from a clinical trial. Data were collected via questionnaires, electronic health records, and participant-collected dried blood spots at three time-points. Lipidomic profiles were measured at all three time points in 49 participants. Using weighted-lipid correlation network analysis, differential lipid analysis, and partial-least squares discriminant analysis, we identified triglyceride (TG)-rich lipid signatures associated with APOs and PPWR. In early pregnancy, three TG networks and seven individual TGs were consistently associated with APOs. Postpartum, several TG networks and individual TGs were associated with APOs and PPWR. These findings highlight TG lipids' crucial role in pregnancy outcomes and the potential of TG-based lipidomic biomarkers for early risk identification to improve maternal and fetal health.