The Association of Early Pregnancy Dyslipidemia with Preterm Birth in Twin Pregnancies: A Retrospective Cohort Study

Abstract

Background Maternal lipid metabolism has been implicated in elevating the risk of adverse pregnancy outcomes. However, the precise relationship between early pregnancy dyslipidemia and the risk of preterm birth in twin pregnancies remains unclear. Methods This retrospective cohort study included women with twin pregnancies between January 2018 and December 2023. Early pregnancy blood lipid profiles, including total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C), were examined. Dyslipidemia was diagnosed based on the diagnostic criteria outlined in the 2016 guidelines for the prevention and treatment of dyslipidemia in Chinese adults. Preterm birth was defined as birth occurring before 37 weeks of pregnancy. Logistic regression models were used to evaluate the association of early pregnancy dyslipidemia with preterm birth in twin pregnancies. Results A total of 613 women with twin pregnancies were included, and 141 women were complicated with dyslipidemia. The incidence of preterm birth in the dyslipidemia group was significantly higher than in the group without dyslipidemia (64.60% vs. 50.40%). After adjusting for confounding factors, dyslipidemia was associated with a higher risk of preterm birth (adjusted OR: 1.71; 95% CI: 1.13–2.58). Nevertheless, thees associations exhibited variability contingent upon the chorionicity and mode of conception of twins. The positive associations between early pregnancy dyslipidemia and preterm birth retained significance solely among spontaneously conceived (SC) twins or dichorionic diamniotic (DCDA) twins. No statistically significant association was observed between dyslipidemia and other secondary outcomes. Conclusion Early pregnancy dyslipidemia was associated with a higher risk of preterm birth in twin pregnancies, with the positive associations persisting significantly among SC twins or DCDA twins. The comprehensive assessment of lipid profiles in the first trimester may prove advantageous for patients monitoring and the implementation of interventions aimed at mitigating adverse pregnancy outcomes.