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Am J Perinatol 2025; 42(14): 1846-1857
DOI: 10.1055/a-2544-9158
Original Article

Association of Maternal Serum Retinol-Binding Protein Levels with Adverse Pregnancy Outcomes: A Retrospective Cohort Study

Authors

  • Wenjing Dong   *

    1   School of Medical Technology and Information Engineering, Zhejiang Chinese Medicine University, Hangzhou, Zhejiang, People's Republic of China

  • Xuelian Chu   *

    2   Department of Laboratory, Maternal and Child Health Hospital of Linping District, Hangzhou, Zhejiang, People's Republic of China

  • Yanan Wang

    2   Department of Laboratory, Maternal and Child Health Hospital of Linping District, Hangzhou, Zhejiang, People's Republic of China

  • Linyuan Gu

    2   Department of Laboratory, Maternal and Child Health Hospital of Linping District, Hangzhou, Zhejiang, People's Republic of China

  • Yiming Chen 

    3   The Fourth School of Clinical Medical, Zhejiang Chinese Medicine University, Hangzhou, Zhejiang, People's Republic of China
    4   Department of Prenatal Diagnosis and Screening Center, Hangzhou Women's Hospital (Hangzhou Maternity and Child Health Care Hospital), Hangzhou, Zhejiang, People's Republic of China

Funding None.
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Abstract

Objective

This study aimed 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 the univariate analysis of qualitative or quantitative data. Multiple logistic regression analysis, odds ratio (OR), 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 low retinol-binding protein (L-RBP), 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 high retinol-binding protein (H-RBP). 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.

Key Points

  • To study the effect of adverse exposure factors on pregnancy outcome and the relationship with RBP.

  • RBP may be a new biomarker that can be used to help stratify pregnancy risk.

  • This study included 16,094 participants and a high number of variables in the analysis.

Keywords

maternal serum - retinol-binding protein - adverse pregnancy outcomes - retrospective cohort study - odds ratio

Ethical Approval

The study was approved by the Medical Ethics Committee of Maternal and Child Health Hospital of Linping District, Hangzhou, and the approval number was LLSC-KYKT-2024-0004-A. The data used in this study were anonymized before use.


Patient Consent

Patient consent was not required as this study was based on publicly available data.


Authors' Contributions

W.D. wrote the first draft of the manuscript. X.C. provided study material or patient information. Y.W. analyzed the statistics and L.G. conducted experimental detection. Y.C. is responsible for writing—review and editing. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved the submission.


* These are co-first authors who contributed equally to this work.




Publication History

Received: 29 October 2024

Accepted: 24 February 2025

Accepted Manuscript online:
25 February 2025

Article published online:
29 March 2025

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