负面的怀孕结果和未来的代谢综合征
Deborah B Ehrenthal1, Rebecca B McNeil2, Emma G Crenshaw2,3
1Social Science Research Institute and Department of Biobehavioral Health, The Pennsylvania State University, University Park, Pennsylvania, USA.
妊娠并发症,如妊娠糖尿病,高血压疾病和早产,增加了几年后代谢综合征 (MetS) 的风险. 这种风险无论怀孕早期的因素如何,都会持续存在,并发症的组合构成了最大的威胁.
科学领域:
- 生殖健康和代谢疾病流行病学.
- 关于母婴健康的纵向队列研究.
- 对代谢综合征的临床风险因素分析.
背景情况:
- 代谢综合征 (MetS) 与不良妊娠结果有关,包括妊娠期糖尿病 (GDM),妊娠高血压障碍 (HDP) 和早产 (PTB).
- 这些妊娠并发症与先前存在的混因子对后来的MetS风险的独立贡献仍然不清楚.
研究的目的:
- 调查GDM,HDP和PTB与MetS发病率在产后2-7年之间的关联.
- 确定这些关联是否独立于早期怀孕的风险因素.
主要方法:
- 从八个美国医疗中心招募了4,402名无卵性个体的纵向队列.
- 收集了人类学,生物标本和调查数据,并从医疗记录中抽取了怀孕结果.
- 估计了MetS的相对风险,调整了早期怀孕的因素,如年龄,BMI,种族/种族,保险和吸烟状况.
主要成果:
- 在随访时,MetS在16.8%的参与者中流行.
- 患有GDM (aRR=1.75),HDP (aRR=1.49) 或PTB (aRR=1.78) 个体的Mets.S.调整后相对风险显著更高.
- 在患有HDP和PTB (aRR=1.95) 的人群中,风险最高.
结论:
- 由GDM,HDP或PTB复杂化的怀孕与产后2-7年内发展MetS的风险增加有关.
- 这种增加的风险是独立于常见的早期怀孕风险因素.
- 结合的HDP和PTB对随后的MetS构成最重要的风险.
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