青少年和年轻成年人的HbA1c水平和不良出生结果
Katharine J McCarthy1,2, Shelley H Liu1, Joseph Kennedy3
1Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York.
JAMA network open
|September 24, 2024
概括
孕前糖尿病显著增加了年轻人患妊娠糖尿病和其他孕产妇健康问题的风险. 在怀孕前优化代谢健康对于降低这些风险至关重要.
科学领域:
- 生殖健康 生殖健康
- 内分泌学 在内分泌学.
- 公共卫生 公共卫生
背景情况:
- 在怀孕前的亚临床高血糖症在年轻人群中没有得到充分的研究.
- 早期发现高血糖是预防孕产妇发病率的关键.
研究的目的:
- 研究妊娠前血红蛋白A1c (HbA1c) 水平与青少年和年轻成年人妊娠糖尿病风险之间的关联.
- 探索二次风险,包括妊娠的高血压疾病,早产,剖腹产和宏观体.
主要方法:
- 使用链接出生登记,医院出院和A1C登记数据 (2009-2017年) 的回顾性队列研究.
- 包括10-24岁的个人,没有先前的糖尿病病史,至少有一次预孕HbA1c测试.
- 逻辑二项式回归分析了妊娠糖尿病的相对风险 (RR),并根据孕前特征进行调整. 接收器操作曲线回归确定了最佳的HbA1c值.
主要成果:
- 孕前糖尿病患者 (HbA1c ≥5.7%) 的妊娠糖尿病风险增加了一倍以上 (aRR, 2.21).
- 前糖尿病与高血压疾病 (aRR,1.18) 和早产 (aRR,1.18) 的风险增加有关.
- 确定妊娠糖尿病风险的最佳HbA1c值为5.6%,西班牙裔个体的较低值为5.5%.
结论:
- 孕前糖尿病与青少年和年轻成年人患母体心脏代谢发病率更高的可能性有关.
- 在怀孕前优化心脏代谢健康可能会减轻孕妇的重大风险.
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