妊娠糖尿病后心血管事件的风险:一个回顾性人口研究
Giuseppe Seghieri1, Elisa Gualdani2, Ilaria Campesi3,4
1Epidemiology Unit, Regional Health Agency of Tuscany, Via Pietro Dazzi, 1, 50141, Florence, Italy. Giuseppe.seghieri@gmail.com.
Acta diabetologica
|May 16, 2024
概括
产后心血管疾病的风险与先前存在的或后来诊断的糖尿病有关,而不仅仅是妊娠糖尿病. 在怀孕之前的孕产妇肥胖显著增加了这种风险.
科学领域:
- 心血管健康的心血管健康
- 内分泌学 在内分泌学.
- 生殖医学是一种生殖医学.
背景情况:
- 孕期糖尿病 (GDM) 影响怀孕,其对心血管疾病 (CVD) 风险的长期影响需要进一步调查.
- 了解GDM,先前存在的糖尿病和产后心血管疾病之间的相互作用对于母亲的健康至关重要.
- 识别与产后心血管疾病相关的风险因素可以为预防策略提供信息.
研究的目的:
- 为了确定妊娠糖尿病 (GDM) 或相关因素是否会导致产后心血管疾病 (CVD) 的风险.
- 研究妊娠前糖尿病 (Pre-GD) 和妊娠后糖尿病 (Post-GD) 对产后心血管疾病的独立和联合影响.
- 评估肥胖等妊娠前风险因素对糖尿病和没有糖尿病的妇女产后心血管疾病的影响.
主要方法:
- 在2010-2012年间在意大利托斯卡纳分娩的74,720名妇女的回顾性队列研究.
- 使用区域行政数据库识别患有GDM,GD前或GD后妇女.
- 评估2013-2021年使用后勤回归模型对心血管疾病 (心肌梗塞,中风) 的产后住院风险.
主要成果:
- 孕期糖尿病 (GDM) 单独并没有与产后心血管疾病风险的增加显著相关.
- 妊娠前糖尿病 (Pre-GD) 和妊娠后糖尿病 (Post-GD) 显著增加了产后心血管疾病的风险.
- 在怀孕前的肥胖 (BMI ≥30 kg/m2) 几乎使心血管疾病风险翻了一番,不管GDM状态如何. 就业与较低的心血管疾病风险有关,而较低的教育水平与更高的风险有关.
结论:
- 产后心血管疾病风险主要是由先前存在的 (GD前) 和后来诊断的 (GD后) 糖尿病驱动的,而不是单独的GDM.
- 怀孕前的肥胖是产后心血管疾病的一个重要,独立的风险因素.
- 像教育水平这样的社会经济因素也在产后心血管健康中发挥作用.
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