A comparison of early pregnancy biomarkers associated with metabolic
health between Indian and European women, from the Screening for
Pregnancy Endpoints (SCOPE) study: a prospective cohort.
Abstract
Objective: Increased rates of pro-inflammatory and metabolic-related
disorders, plus perinatal death and other pregnancy complications such
as gestational diabetes (GDM), are consistently reported among women of
Indian ethnicity. This study compares lipid profiles and early pregnancy
biomarkers associated with metabolic dysfunction between healthy
nulliparous pregnant women of Indian and European ethnicity. Design: a
prospective cohort study. Setting: Australia, Ireland, New Zealand and
the United Kingdom; 2004-2011. Population: 138 and 5,240 women of Indian
and European ethnicity were included from the prospective Screening for
Pregnancy Endpoints cohort study. Methods: Early pregnancy biomarkers
were selected a priori on the basis of a potential association
with the metabolic syndrome, diabetes/GDM or obesity, and compared
between ethnic groups. Biomarkers that differed significantly between
ethnic groups were adjusted for maternal age, body mass index, smoking,
alcohol use and socioeconomic status. Main outcome measures: Mean values
for 21 placental, metabolic, inflammatory and cardiovascular biomarkers,
plus blood lipids, measured at 15±1 weeks gestation. Results: Ten
biomarkers were significantly different by ethnicity, mostly consistent
with a pro-inflammatory and less favourable metabolic profile in Indian
women: PlGF (p=0.02), adiponectin (p<0.01), NGAL
(p<0.01), TNFR1A (p<0.01), CXCL10 (p=0.01), ICAM-1
(p<0.01), ST2 (p<0.01), angiogenin
(p<0.01), and proANP (p<0.01). We additionally found
increased triglycerides (1.6±0.6 vs 1.5±0.6, p<0.01) and
reduced HDL cholesterol (1.7±0.4 vs 1.9±04, p<0.01) in Indian
mothers, compared with European. Conclusions: Low-risk mothers of Indian
ethnicity have an overall less favourable metabolic health profile at
early gestation compared with European women. Future research should
investigate the association with pregnancy outcomes.