Association of maternal serum retinol-binding protein levels with adverse pregnancy outcomes: A retrospective cohort study.

Objectives: To determine the correlation between decreased or increased retinol-binding protein (RBP) levels during pregnancy and adverse pregnancy outcomes.

Study design: A retrospective cohort study was conducted to analyze the data of 16,094 pregnant women who participated in serum RBP level detection during pregnancy. The chi-square test or Mann-Whitney U test was used for univariate analysis of qualitative or quantitative data. Multiple logistic regression analysis, odds ratio, and 95% confidence interval were used to evaluate the effect of RBP levels on adverse pregnancy outcomes.

Results: The groups showed a significant difference in RBP levels (P < 0.001). The results of multiple logistic regression analysis revealed that twins (OR=2.631), upper respiratory tract infection (URTI, OR=2.596), premature delivery (OR=1.833), and macrosomia (OR=1.524), were correlated with L-RBP (low retinol-binding protein), while preeclampsia (PE, OR=0.147), intrahepatic cholestasis of pregnancy (OR=1.654), gestational hypertension (GH, OR=1.646), oligohydramnios (OR=1.487), and advanced maternal age (OR=1.470) were correlated with H-RBP (high retinol-binding protein). Decreased or increased RBP levels were correlated with hyperlipidemia (OR=1.738, 2.857), Antenatal anemia (OR=1.378, 0.791), gestational diabetes mellitus (GDM, OR=1.272, 0.796), and small infant size (OR=0.664, 1.444). L-RBP may indicate an increased risk of antenatal anemia and GDM, whereas H-RBP may indicate a decreased risk of antenatal anemia and GDM. Pregnant women with H-RBP were more likely to give birth to smaller infants, whereas those with L-RBP had a lower risk of this outcome. Additionally, mothers with H-RBP were not likely to give birth to male infants.

Conclusion: Hyperlipidemia, URTI, GH, PE, and GDM affect serum RBP levels, and these exposure factors can lead to different degrees of adverse pregnancy outcomes.