阿尔伯塔省的梅蒂斯人怀孕期间的糖尿病:一项回顾性队列研究
Britt Voaklander1, Omolara Sanni1, Jesus Serrano-Lomelin1
1School of Public Health (Voaklander, Eurich), and Department of Obstetrics and Gynecology (Sanni, Serrano-Lomelin, Ospina), University of Alberta; Métis Nation of Alberta (James, Cordingley, Bartel), Edmonton, Alta.; Department of Public Health Sciences (Ospina), Queen's University, Kingston, Ont.
当地的怀孕,特别是梅蒂斯人,显示出更高的先前存在和妊娠糖尿病的比率. 这增加了诸如孕前症和妊娠年龄较大的婴儿等疾病的风险,突出了迫切的公共卫生需求.
科学领域:
- 生殖健康 生殖健康
- 公共卫生 公共卫生
- 土著健康土著健康
背景情况:
- 怀孕期间的糖尿病是土著居民的重大公共卫生问题.
- 评估梅蒂斯怀孕中糖尿病患病率和结果至关重要.
研究的目的:
- 评估在加拿大阿尔伯塔省的梅蒂斯怀孕中与非梅蒂斯怀孕相比,先前存在的和妊娠期糖尿病的患病率.
- 为了比较梅蒂斯和非梅蒂斯怀孕之间的孕产妇和新生儿后果.
主要方法:
- 使用行政卫生数据 (2006-2016) 和阿尔伯塔省梅蒂斯民族识别登记册的回顾性队列研究.
- 比较先前存在的和妊娠糖尿病的患病率和10个梅蒂斯和非梅蒂斯出生之间的母亲/新生儿结局.
- 多变量分析使用调整的几率比率 (ORs) 和95%的置信区间 (CI).
主要成果:
- 这项研究包括了7902名梅蒂斯人和471,886名非梅蒂斯人的出生.
- 梅蒂斯女性怀孕的预先存在的糖尿病 (1.7%对1.1%) 和妊娠期糖尿病 (6.3%对5.4%) 的年龄标准化患病率较高.
- 经过调整后的分析显示,梅蒂斯妇女怀孕的预先存在糖尿病的几率是1.72倍,孕期糖尿病的几率是1.30倍. 预先存在的糖尿病的梅蒂斯怀孕几乎有3倍的孕前的几率,而那些患有妊娠糖尿病的孕妇则有48%的更高的孕期婴儿.
结论:
- 与非梅蒂斯怀孕相比,梅蒂斯怀孕的预先存在和妊娠糖尿病的患病率增加.
- 这些怀孕面临着不良周产期结果的高风险,包括先兆子和分娩大的孕期婴儿.
- 干预措施必须解决生理和文化因素,并纳入梅蒂斯人的观点,以减少健康不平等.
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