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Research Article: Association between atherogenic index of plasma in early pregnancy and risk of preeclampsia: a multicenter cohort study

Date Published: 2026-06-18

Abstract:
This study aimed to investigate the relationship between atherogenic index of plasma (AIP) and preeclampsia (PE). This retrospective multicenter observational cohort study included 2,162 preeclampsia cases and 36,660 normal controls who met the eligibility criteria. AIP was measured before 20 weeks of gestation and calculated as log10 [TG (mmol/L)/HDL-C (mmol/L)]. Participants were divided into four groups according to AIP quartiles (Q1–Q4). Multivariable logistic regression, subgroup analysis, and smooth curve fitting were applied to examine the association between AIP and PE, as well as related adverse pregnancy outcomes. After adjusting for confounding factors, multivariable logistic regression analysis revealed that participants in the Q3 and Q4 groups had significantly higher risks of PE and gestational diabetes mellitus with preeclampsia (GDM&PE) compared with those in the Q1 group. The magnitude of the independent association was modest: every 0.1 increase in AIP was associated with an 8% higher risk of PE (OR = 1.08, 95% CI: 1.05–1.10, P < 0.0001) and a 13% higher risk of GDM&PE (OR = 1.13, 95% CI: 1.07–1.19, P < 0.0001). Subgroup analyses further showed that the association between AIP and PE was not affected by maternal age, BMI, or parity. Additionally, a nonlinear dose-response association was observed between AIP and PE risk. In this retrospective observational cohort, elevated AIP in early pregnancy was associated with higher risks of PE and GDM&PE, although the adjusted effect sizes were modest. AIP may be considered a potential risk marker for PE and GDM&PE.

Introduction:
This study aimed to investigate the relationship between atherogenic index of plasma (AIP) and preeclampsia (PE).

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