A large Swedish cohort found cardiometabolic biomarkers measured up to decades before pregnancy were associated with hypertensive disorders — with risk apparent even below standard diagnostic thresholds.
To investigate the association between cardiometabolic biomarkers measured prior to pregnancy and the risk of hypertensive disorders of pregnancy (HDP).
Key Findings:
Lipid-related biomarkers showed the strongest associations with HDP risk.
Women in the highest quartile of apolipoprotein B had 1.9 times the odds of HDP.
Non–high-density lipoprotein cholesterol showed more than twice the odds of HDP at dyslipidemia thresholds.
Glucose-related findings were mixed; diagnosed diabetes was associated with nearly twice the odds of HDP.
Higher haptoglobin levels were associated with increased odds of HDP, while C-reactive protein and leukocyte count were not.
Interpretation:
The study suggests that cardiometabolic risk factors may precede and contribute to HDP risk, with implications for preconceptional counseling. However, the observational nature limits causality conclusions.
Limitations:
The study is observational and cannot establish causality.
Biomarkers were measured years prior and may not reflect levels at conception.
Generalizability may be limited to nulliparous women with pregestational lab testing.
Conclusion:
Assessment of cardiometabolic biomarkers may improve identification of women at risk of HDP, though immediate clinical application is limited due to the exploratory nature of the analyses.
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