子痫前期与妊娠期糖尿病：妊娠早期是否存在相关性？

Pre-eclampsia and gestational diabetes mellitus: does a correlation exist early in pregnancy?

作者信息

Yogev Y, Langer O, Brustman L, Rosenn B

机构信息

Department of Obstetrics and Gynecology, St Luke's-Roosevelt Hospital Center, University Hospital of Columbia University, New York, New York 10019, USA.

出版信息

J Matern Fetal Neonatal Med. 2004 Jan;15(1):39-43. doi: 10.1080/14767050310001650707.

DOI:10.1080/14767050310001650707

PMID:15101610

Abstract

OBJECTIVE

We investigated whether blood pressure profile early in pregnancy was associated with the development of pre-eclampsia in patients with gestational diabetes mellitus (GDM).

METHODS

A retrospective longitudinal database study of 1664 GDM subjects was performed. Systolic and diastolic blood pressure measurements were taken bi-weekly during the first and second trimesters. GDM patients who developed pre-eclampsia were compared to GDM patients who did not. Subjects were further stratified by maternal age, parity, race, prepregnancy body mass index (BMI) and weight gain during pregnancy. Logistic regression was performed to identify the net effect of each factor on the development of pre-eclampsia.

RESULTS

Overall, 167/1664 (10%) GDM patients developed pre-eclampsia. GDM patients who developed pre-eclampsia were more obese, gained more weight during pregnancy and had more severe GDM in comparison to GDM patients who did not. Although all mean blood pressure measurements were within the normal range, significantly higher systolic and diastolic values were recorded in the GDM patients who developed pre-eclampsia throughout the first and the second trimesters of pregnancy. Logistic regression revealed that higher parity (p = 0.04), maternal age (p = 0.03) and pre-pregnancy BMI (p = 0.03) were all contributing factors to pre-eclampsia. In contrast, weight gain during pregnancy and race were not related.

CONCLUSION

In GDM patients, higher blood pressure readings early in pregnancy, even prior to GDM diagnosis, were associated with the subsequent development of pre-eclampsia.

摘要

目的

我们研究了妊娠早期的血压情况是否与妊娠期糖尿病（GDM）患者子痫前期的发生有关。

方法

对1664例GDM患者进行了一项回顾性纵向数据库研究。在妊娠的前三个月和第二个三个月期间，每两周测量一次收缩压和舒张压。将发生子痫前期的GDM患者与未发生子痫前期的GDM患者进行比较。根据产妇年龄、产次、种族、孕前体重指数（BMI）和孕期体重增加情况对受试者进行进一步分层。进行逻辑回归分析以确定每个因素对子痫前期发生的净影响。

结果

总体而言，1664例GDM患者中有167例（10%）发生了子痫前期。与未发生子痫前期的GDM患者相比，发生子痫前期的GDM患者更肥胖，孕期体重增加更多，GDM病情更严重。尽管所有平均血压测量值均在正常范围内，但在整个妊娠的前三个月和第二个三个月期间，发生子痫前期的GDM患者的收缩压和舒张压值明显更高。逻辑回归分析显示，产次增加（p = 0.04）、产妇年龄（p = 0.03）和孕前BMI（p = 0.03）都是子痫前期的促成因素。相比之下，孕期体重增加和种族无关。