The association between serum levels of complement factors B, H and the risk of preeclampsia (PE) in gestational diabetes mellitus (GDM) patients remains unclear.

A total of 503 GDM patients attended GDM education class at Peking University Third Hospital(PUTH) from March 2018 to December 2018. 456 cases were followed until delivery and blood samples were collected during 24–28 gestational weeks to clarify the potential association.

Elevated serum levels of FB in mid-pregnancy may be a potential predictor of predicting the risk of PE in GDM patients. The combination of complement factor B (FB), complement factor H (FH) and triacylglycerol (TG) increased the predictive value.

We aimed to define the relationships between the serum concentrations of complement factors B and H in mid-pregnancy and the risk of preeclampsia (PE) in patients with gestational diabetes mellitus (GDM).

We performed a prospective nested case–control study of 503 patients with GDM who attended Peking University Third Hospital between March 2018 and December 2018. 456 patients were followed until delivery and blood samples were collected between gestational weeks 24 and 28. Thirty patients developed PE, 12 developed gestational hypertension (GH), and 42 matched cases were selected as a control group.

The incidence of PE was 5.96 %. The serum concentrations of triacylglycerol (TG), FB, and FH of women with GDM who developed PE (GDM-PE group) in mid-pregnancy were significantly higher than those of the GDM group [TG: 3.60 (2.94–4.63) vs 2.54 (2.14–3.01) mmol/L, p < 0.001; FB: 346 (314–378) vs 284 (263–323) mg/L, p < 0.001; FH: 417 ± 45 vs 379 ± 47 mg/L, p = 0.003]. Multivariate regression analysis showed that high serum concentrations of TG and FB in mid-pregnancy were related to the risk of patients with GDM developing PE [TG: odds ratio (OR) 2.035 (95 % confidence interval (CI) 1.032–4.013); FB: OR 1.018 (95 % CI 1.001–1.035)]. The area under the curve (AUC) of FB for the prediction of PE was 0.821 (95 % CI 0.722–0.921) and that for a combination of TG, FB, and FH was 0.857 (95 % CI 0.770–0.944).

High serum FB concentration during mid-pregnancy is a potential predictor of the risk of PE in patients with GDM, and the combination of FB, FH, and TG increased this predictive value.

Gestational diabetes mellitus

Gestational hypertension

Preeclampsia

Complement factor B

Complement factor H

Triacylglycerol

© 2022 Peking University Third Hospital. Published by Elsevier B.V. on behalf of International Society for the Study of Hypertension in Pregnancy.