母亲糖尿病和超重以及子女的先天性心脏缺陷
Riitta Turunen1,2, Anna Pulakka2,3, Johanna Metsälä2
1Pediatric Research Center, New Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
JAMA network open
|January 5, 2024
概括
母亲1型糖尿病 (T1D) 显著增加后代先天性心脏缺陷 (CHD) 的风险. 孕产妇超重和肥胖与特定的冠状动脉疾病有关,这表明不同的发育影响.
科学领域:
- 生殖医学 生殖医学
- 儿童心脏病学 儿童心脏病学
- 公共卫生 公共卫生
背景情况:
- 孕产妇糖尿病和孕前超重/肥胖是先天性心脏缺陷 (CHD) 的确立危险因素.
- 有限的大规模研究同时模拟了这些母性因素及其对后代CHD的影响.
研究的目的:
- 研究母亲糖尿病和超重/肥胖与后代心血管疾病风险的联合关联.
- 在统一的模型中,分析特定的CHD子组与这些孕产妇风险因素相关.
主要方法:
- 全国范围,芬兰 (2006-2016) 基于人口的出生队列研究,包括620751名儿童及其母亲.
- 评估了母亲的孕前体重指数 (BMI) 和糖尿病状态 (没有糖尿病,1型糖尿病[T1D],2型/其他糖尿病,妊娠期糖尿病).
- 单独的CHD和9个解剖学CHD亚组的几率比率 (ORs) 被计算和分析.
主要成果:
- 孕产妇T1D与任何心脏病 (OR,3.77) 和9个特定心脏病子组中的6个心脏病的几率增加有显著的关联.
- 产妇超重与左心室外流通道阻塞 (OR,1.28) 和心室隔膜缺陷 (OR,0.92) 有关.
- 孕产妇的肥胖与复杂缺陷 (OR,2.70) 和右流出管道阻塞 (OR,1.31) 有关.
结论:
- 孕产妇T1D对后代的各种CHD有很大的风险.
- 孕产妇超重和肥胖与特定类型的心血管疾病有关,包括复杂缺陷和流出管道阻塞.
- 截然不同的风险概况表明,孕产妇T1D与超重/肥胖的潜在不同的潜在原性机制可能不同.
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