Serum transthyretin, Maternal comorbidities, Non-linear relationship, Gestational diabetes mellitus, Preeclampsia, Gynecology and obstetrics, RG1-991

Abstract Objective This study aims to explore the association of maternal serum transthyretin (TTR) concentrations with adverse pregnancy and birth outcomes, as well as the variations in TTR concentrations across different gestational weeks in relation to these outcomes. Methods This retrospective cohort study included 6,584 women who delivered at The Second Affiliated Hospital of Wenzhou Medical University between January 1, 2022 and January 30, 2024. Logistic regression and Restricted cubic spline (RCS) models were applied to evaluate the association between TTR levels and the risk of complications, based on TTR quartile analyses. Locally estimated scatter plot smoothing (LOESS) curves were performed to provide a graphical representation of the relationship between TTR levels and gestational weeks. Results Significant negative correlations were observed between maternal TTR levels and the risk of gestational diabetes mellitus (GDM), preeclampsia (PE), liver disease, anemia during pregnancy, and preterm delivery (all P