Long-Term Risk of Type 2 Diabetes After Preterm Delivery or Hypertensive Disorders of Pregnancy.

IF 8.3 2区 材料科学 Q1 MATERIALS SCIENCE, MULTIDISCIPLINARY
ACS Applied Materials & Interfaces Pub Date : 2024-11-01 Epub Date: 2024-05-09 DOI:10.1097/AOG.0000000000005604
Casey Crump, Jan Sundquist, Kristina Sundquist
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引用次数: 0

Abstract

Objective: To examine long-term diabetes risk after preterm delivery or hypertensive disorders of pregnancy in a large population-based cohort.

Methods: This retrospective cohort study included all women with a singleton delivery in Sweden during 1973-2015 and no preexisting diabetes mellitus. Participants were followed up for development of type 2 diabetes identified from nationwide outpatient and inpatient diagnoses through 2018. Cox regression was used to compute hazard ratios (HRs) for the association between preterm delivery or hypertensive disorders of pregnancy and type 2 diabetes with adjustment for gestational diabetes and other maternal factors. Co-sibling analyses assessed for confounding by shared familial (genetic or environmental) factors.

Results: Overall, 2,184,417 women were included. Within 10 years after delivery, adjusted HRs for type 2 diabetes associated with specific pregnancy outcomes were as follows: any preterm delivery (before 37 weeks of gestation), 1.96 (95% CI, 1.83-2.09); extremely preterm delivery (22-27 weeks), 2.53 (95% CI, 2.03-3.16); and hypertensive disorders of pregnancy, 1.52 (95% CI, 1.43-1.63). All HRs remained significantly elevated (1.1-1.7-fold) 30-46 years after delivery. These findings were largely unexplained by shared familial factors.

Conclusion: In this large national cohort, preterm delivery and hypertensive disorders of pregnancy were associated with increased risk for type 2 diabetes up to 46 years later. Women with these pregnancy complications are candidates for early preventive actions and long-term monitoring for type 2 diabetes.

早产或妊娠高血压疾病后罹患 2 型糖尿病的长期风险。
目的在一个大型人群队列中研究早产或妊娠高血压疾病后的长期糖尿病风险:这项回顾性队列研究纳入了 1973-2015 年间瑞典所有单胎分娩且未患糖尿病的女性。对参与者进行随访,从全国范围内的门诊和住院病人诊断中确定其是否发展为 2 型糖尿病,直至 2018 年。在对妊娠期糖尿病和其他母亲因素进行调整后,采用 Cox 回归计算早产或妊娠期高血压疾病与 2 型糖尿病之间关系的危险比 (HRs)。同胞分析评估了共同家族(遗传或环境)因素的干扰:共纳入 2 184 417 名妇女。产后 10 年内,与特定妊娠结局相关的 2 型糖尿病调整 HRs 如下:任何早产(妊娠 37 周前),1.96(95% CI,1.83-2.09);极早产(22-27 周),2.53(95% CI,2.03-3.16);妊娠高血压疾病,1.52(95% CI,1.43-1.63)。所有 HRs 在产后 30-46 年仍明显升高(1.1-1.7 倍)。这些结果在很大程度上无法用共同的家族因素来解释:结论:在这一大型全国性队列中,早产和妊娠高血压疾病与 46 年后 2 型糖尿病风险的增加有关。患有这些妊娠并发症的妇女应及早采取预防措施,并对 2 型糖尿病进行长期监测。
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来源期刊
ACS Applied Materials & Interfaces
ACS Applied Materials & Interfaces 工程技术-材料科学:综合
CiteScore
16.00
自引率
6.30%
发文量
4978
审稿时长
1.8 months
期刊介绍: ACS Applied Materials & Interfaces is a leading interdisciplinary journal that brings together chemists, engineers, physicists, and biologists to explore the development and utilization of newly-discovered materials and interfacial processes for specific applications. Our journal has experienced remarkable growth since its establishment in 2009, both in terms of the number of articles published and the impact of the research showcased. We are proud to foster a truly global community, with the majority of published articles originating from outside the United States, reflecting the rapid growth of applied research worldwide.
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