Association between insulin resistance trajectories and perinatal complications: a retrospective cohort study
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By
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March 30, 2026
Objective:
To investigate the correlation and influencing factors between different levels of insulin resistance (IR) during pregnancy and adverse pregnancy outcomes, and to suggest a critical threshold for predicting pathological IR, defined as IR levels significantly higher than normal.
Key Findings:
- Four distinct IR change trajectories were identified: low level, moderate level, high level, and low-high level.
- Moderate and high-level IR trajectories were associated with increased risk of gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP), with aRR values of 1.73 and 2.40 respectively.
- The low-high level trajectory showed a significantly higher risk for HDP compared to the high level trajectory, with aRR of 6.45.
- Fasting serum insulin (FINS) had the highest predictive ability for HDP with an AUC of 0.740.
Interpretation:
The study highlights the importance of monitoring insulin resistance trajectories during pregnancy as they are significantly correlated with adverse outcomes, suggesting potential for early intervention strategies such as lifestyle modifications or medical management.
Limitations:
- The study is retrospective and may be subject to selection bias, potentially affecting the validity of the findings.
- Data was collected from a single hospital, which may limit generalizability.
Conclusion:
Various subtypes of insulin resistance trajectories in pregnant women are significantly correlated with adverse pregnancy outcomes, indicating the need for monitoring and potential intervention.
