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.

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.