怀孕的结果 口服葡萄糖耐受性测试和早产
Richard Liang1, Danielle M Panelli2, David K Stevenson3
1From the Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA.
怀孕期间葡萄糖水平升高,即使低于妊娠糖尿病诊断值,也会增加早产风险. 肥胖可能会改变这种关联,强调需要在孕妇中仔细监测葡萄糖的必要性.
科学领域:
- 产科和妇科 产科和妇科
- 内分泌学 在内分泌学.
- 公共卫生 公共卫生
背景情况:
- 孕期糖尿病与诸如早产等不良妊娠结果有关.
- 对于妊娠糖尿病查和诊断的国际指南缺乏共识.
- 身体质量指数 (BMI) 和肥胖症在修改葡萄糖-早产关系中的作用尚不清楚.
研究的目的:
- 调查怀孕期间葡萄糖水平与早产之间的关联.
- 为了确定肥胖是否会改变葡萄糖水平与早产风险之间的关系.
主要方法:
- 一项使用丹麦医疗出生登记册 (2004-2018) 数据的队列研究.
- 分析了2小时后的75克口服葡萄糖耐受性测试结果在11,337个怀孕.
- 用Poisson回归来估计早产率比率 (RR),用分层来评估肥胖影响的修改 (BMI ≥30).
主要成果:
- 观察到高葡萄糖水平增加了早产的风险,甚至低于妊娠糖尿病诊断值.
- 一个标准偏差增加的葡萄糖 (1.4 mmol/l) 与20%的早产风险增加有关 (aRR = 1.2).
- 肥胖 (BMI ≥30) 显示了改变葡萄糖水平与早产风险之间的关联的证据 (异质性P = 0.05).
结论:
- 增加的母体葡萄糖水平,即使低于妊娠糖尿病诊断标准,也与早产风险更高有关.
- 肥胖似乎是一个效果修饰者,而不仅仅是一个混者,在葡萄糖水平和早产之间的关系中.
- 这些发现强调了怀孕期间血糖监测的重要性,特别是在肥胖个体中,以减轻早产风险.
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