Association between glycolipid metabolism 7 factors (GLM7) and pregnancy loss in women aged 18-35 years: evidence from NHANES 2009-2018.

backgroundGrowing evidence suggests that metabolic disturbances underlie pregnancy losses, imposing a substantial public health burden among young women of reproductive age. Glycolipid metabolism 7 factors (GLM7) is a composite glycolipid metabolism index derived from routinely measured metabolic indicators; however, its relevance to pregnancy loss in young women remains unexamined.

methodsThe present study analyzed publicly available data from the 2009-2018 National Health and Nutrition Examination Survey (NHANES) cycles. Participants were categorized as having no pregnancy loss, single pregnancy loss, or recurrent pregnancy loss (≥ 2 losses). GLM7 was calculated as the logarithm of the product of age, body mass index, fasting blood glucose, fasting insulin, triglycerides, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol levels. The association between GLM7 and pregnancy loss categories was evaluated, potential dose-response patterns were explored, and effect modification by selected sociodemographic and behavioral factors was assessed.

resultsOf the 736 women included in the analysis, 300 (37%) reported a history of pregnancy loss. In binary analyses, higher GLM7 was initially associated with pregnancy loss (OR = 1.21, 95% CI: 1.03-1.44); however, the association was attenuated after adjustment for the number of pregnancies (OR = 1.19, 95% CI: 0.99-1.44). In multinomial analyses, higher GLM7 levels were not significantly associated with single pregnancy loss. In contrast, higher GLM7 remained independently associated with recurrent pregnancy loss after adjustment for all covariates (OR = 1.17, 95% CI: 1.02-1.42; P = 0.046). Women in the second to fourth quartiles had significantly higher odds of recurrent pregnancy loss than those in the lowest quartile. No significant nonlinearity was observed in the association between GLM7 and recurrent pregnancy loss (P for nonlinearity = 0.265). No statistically significant interaction was observed across the subgroups.

conclusionsIn this nationally representative sample of U.S. women aged 18-35 years, higher GLM7 levels were more robustly associated with recurrent rather than isolated pregnancy loss. The findings suggested that cumulative glycolipid metabolic burden may be particularly relevant to repeated reproductive failures and serve as indicators to improved strategies for early reproductive risk identification and preventive healthcare for women.