Objective To evaluate the risk of different types of preterm delivery in pregnant women with different types of metabolic abnormalities during pregnancy.

Methods This study was a retrospective cohort study. Health information of women delivered between May 1, 2021 and December 31, 2021, in Beijing Obstetrics and Gynecology Hospital was collected retrospectively using the Hospital Information System and self-made questionnaire, and their neonatal outcomes were observed. According to the new high-risk infant classification framework, preterm infants are divided into two categories: preterm infants suitable for gestational age (AGA) and preterm infants small for gestational age (SGA). Chi-square test was used to compare the differences in types of preterm delivery among pregnant women with different types of metabolic abnormalities, and logistic regression model was used to calculate the risk value of preterm delivery in pregnant women with various metabolic abnormalities.

Results A total of 7 233 pregnant women were included in the study. The incidence of hyperglycemia, hypertension disorders, triglyceride > 3.68 mmol/L and pre-pregnancy obesity were 20.8%, 9.9%, 23.8%, and 5.3%. respectively. The incidence of AGA and SGA were 5.5% and 1.0% respectively. There was a moderate association between hyperglycemia and preterm AGA delivery (OR = 1.92, 95% CI: 1.49 − 2.45), but no significant association was observed between hyperglycemia and preterm SGA delivery (OR = 1.28, 95% CI: 0.70 − 2.24). No association was observed between maternal obesity and preterm AGA (OR = 1.20, 95% CI: 0.77 − 1.81) or preterm SGA delivery (OR = 0.281, 95% CI: 0.70 − 2.24). Gestational hypertensive disorders has a weak association with preterm AGA delivery (OR = 1.43, 95% CI: 1.01 − 1.99), but a strong association with preterm SGA delivery (OR = 7.40, 95% CI: 4.26 − 12.77). Pregnant women with high triglyceride levels had an increased risk of preterm AGA delivery (OR = 1.35, 95% CI: 1.05 to 1.71), but no increased risk of preterm SGA delivery was observed (OR = 1.14, 95% CI: 0.65 to 1.95).

Conclusion Pregnant women with different metabolic abnormalities have different risk values for preterm SGA and preterm AGA, and prenatal care management should be paid to them accordingly.