在产后24个月内妊娠糖尿病和心血管疾病之间的关联
Christina M Ackerman-Banks1, Kristin Palmsten2, Heather S Lipkind3
1Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX (Dr Ackerman-Banks).
American journal of obstetrics & gynecology MFM
|April 5, 2024
概括
孕期糖尿病女性在产后24个月内面临更高的短期风险,可能患上新的慢性高血压. 早期对高血压进行查对于这些人来说至关重要.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 公共卫生 公共卫生
背景情况:
- 心血管疾病 (CVD) 是美国女性的主要死亡原因.
- 孕期糖尿病 (GDM) 与长期心脏代谢风险有关,但短期心血管疾病风险尚不清楚.
- 在GDM患者中识别短期心血管疾病风险可以指导早期干预.
研究的目的:
- 为了比较患有GDM和没有GDM的患者之间的心血管疾病诊断的24个月产后风险.
- 调查GDM与特定的短期心血管结果之间的关联.
主要方法:
- 使用缅因州所有付款人索赔数据库 (2007-2019) 进行了基于人口的纵向研究.
- 包括孕妇,但不包括特定的高风险或不完整的记录.
- 确定了GDM和CVD (心力衰竭,缺血性心脏病,中风等) 使用ICD代码;使用Cox比例危险模型进行分析.
主要成果:
- 在84,746个怀孕中,GDM患者在产后24个月内患新慢性高血压的风险更高 (aHR,1.56).
- 没有发现GDM与缺血性心脏病,中风,心律不整/心脏骤停或心肌病的显著关联.
- 在产后24个月内,GDM患者心力衰竭风险降低 (aHR,0.45).
结论:
- 在产后2年内,GDM显著增加了新的慢性高血压的风险,这在很大程度上独立于患上糖尿病.
- 患有GDM的妇女需要在产后早期对新的慢性高血压进行警监测和查.
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