2006年至2019年糖尿病少女妊娠中的早产和高血压疾病

IF 3.9 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Pediatric Diabetes Pub Date : 2024-01-01 Epub Date: 2024-10-18 DOI:10.1155/2024/2283730

Estelle Everett, Christina S Han, Michael Richley, Timothy P Copeland, Tannaz Moin, Lauren E Wisk

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引用次数: 0

摘要

目的：我们试图评估伴有和不伴有糖尿病的青少年妊娠发生早产和高血压疾病的风险。方法：对2006年、2009年、2012年、2016年和2019年全国儿童住院数据库（KID）中分娩和分娩住院的1,843,139名青少年（≤20岁）进行评估。使用国际疾病代码分类来确定糖尿病和影响妊娠的医学因素。采用加权logistic回归评估糖尿病与并发症之间的关系。结果：入院患者中，0.2%患有1型糖尿病（T1D）， 0.2%患有2型糖尿病（T2D）， 0.7%患有妊娠糖尿病（GDM）；10.1%的入院患者合并高血压疾病，5.8%的入院患者合并早产。与未患糖尿病的青少年相比，糖尿病患者高血压疾病的患病率更高(T1D: 35.4%, T2D: 37.8%, GDM: 24.9%，无糖尿病：9.9%；结论：糖尿病在青少年中呈上升趋势，是早产和高血压疾病的重要危险因素。虽然少女怀孕的绝对数字正在下降，但高血压疾病的发病率却有所上升。需要采取适当的干预措施，以确保怀孕的青少年获得健康的结果。

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Preterm Labor and Hypertensive Disorders in Adolescent Pregnancies With Diabetes Between 2006 and 2019.

Objective: We sought to evaluate the risk of preterm labor and hypertensive disorders in adolescent pregnancies with and without diabetes.

Methods: We evaluated 1,843,139 adolescents (≤20 years old) with labor and delivery admissions in the national Kids' Inpatient Database (KID) in years 2006, 2009, 2012, 2016, and 2019. International classification of disease codes was used to identify diabetes and medical factors affecting pregnancy. Weighted logistic regression was used to evaluate the association between diabetes and complications.

Results: Among admissions, 0.2% had type 1 diabetes (T1D), 0.2% had type 2 diabetes (T2D), and 0.7% had gestational diabetes (GDM); 10.1% of admissions were complicated by hypertensive disorders and 5.8% by preterm labor. Compared to adolescents without diabetes, those with diabetes had a higher prevalence of hypertensive disorders (T1D: 35.4%, T2D: 37.8%, GDM: 24.9%, None: 9.9%; p <0:001) and preterm labor (T1D: 21.5%, T2D: 16.8%, GDM: 6.8%, none: 5.7%; p <0:001). In adjusted models, odds of hypertensive disorders were higher in later study years (2019 vs. 2006 OR 1.85, 95% CI 1.77-1.94), among those with T1D (OR 4.32, 95% CI 3.94-4.74), with T2D (OR 4.18, 95% CI 3.79-4.61), and with GDM (OR 1.99, 95% CI 1.89-2.10). Adjusted odds of preterm labor were higher among those with T1D (OR 4.53, 95% CI 4.09-5.02), with T2D (OR 3.35, 95% CI 2.96-3.78), and with GDM (OR 1.18, 95% CI 1.08-1.28); disparities were seen by race/ethnicity, insurance, and income.

Conclusions: Diabetes, which is increasing among adolescents, is a significant risk factor for preterm labor and hypertensive disorders. Though the absolute number of adolescent pregnancies is decreasing, rates of hypertensive disorders have increased. Appropriate interventions are needed to ensure healthy outcomes for adolescents who are pregnant.

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来源期刊

Pediatric Diabetes 医学-内分泌学与代谢

CiteScore

6.60

自引率

14.70%

发文量

141

审稿时长

4-8 weeks

期刊介绍： Pediatric Diabetes is a bi-monthly journal devoted to disseminating new knowledge relating to the epidemiology, etiology, pathogenesis, management, complications and prevention of diabetes in childhood and adolescence. The aim of the journal is to become the leading vehicle for international dissemination of research and practice relating to diabetes in youth. Papers are considered for publication based on the rigor of scientific approach, novelty, and importance for understanding mechanisms involved in the epidemiology and etiology of this disease, especially its molecular, biochemical and physiological aspects. Work relating to the clinical presentation, course, management and outcome of diabetes, including its physical and emotional sequelae, is considered. In vitro studies using animal or human tissues, whole animal and clinical studies in humans are also considered. The journal reviews full-length papers, preliminary communications with important new information, clinical reports, and reviews of major topics. Invited editorials, commentaries, and perspectives are a regular feature. The editors, based in the USA, Europe, and Australasia, maintain regular communications to assure rapid turnaround time of submitted manuscripts.