Levy Amalia, Wiznitzer Arnon, Holcberg Gershon, Mazor Moshe, Sheiner Eyal
Faculty of Health Sciences, Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben Gurion University of the Negev, Be'er-Sheva, Israel.
J Matern Fetal Neonatal Med. 2010 Feb;23(2):148-52. doi: 10.3109/14767050903156650.
To test the association between familial history of diabetes mellitus and birth-weight as well as mode of delivery stratified for the presence of the disease.
A population-based study, comparing birth outcome of patients with and without familial history of diabetes mellitus was conducted. Patients lacking prenatal care were excluded from the analysis. Multiple logistic regression models were used to control for confounders. The Mantel-Haenszel procedure was used to obtain the weighted odds ratios while controlling for the presence of diabetes mellitus (either gestational or pre-gestational).
Out of 181,479 deliveries, 7.6% (n = 13,813) were in patients with familial history of diabetes mellitus. These patients had higher rates of diabetes mellitus (either gestational or pre-gestational) as compared with patients without familial history of diabetes mellitus (13.7% vs. 6.3%, OR = 2.3; 95% CI 2.2-2.5, p < 0.001). Patients with familial history of diabetes mellitus had higher rates of macrosomia (birth-weight >4 kg; 5.7% vs. 4.6%, p < 0.001). Also, a 1.3-fold increase in the risk for cesarean delivery (CD) was found in patients with familial history of diabetes mellitus as compared with the comparison group (17.1% vs. 13.8%, p < 0.001). Using two different multiple logistic regression models, one with CD and the second with macrosomia as the outcome variable, the association between familial history of diabetes mellitus and these complications remained significant (OR = 1.2; 95% CI 1.1-1.2; p < 0.001 and OR = 1.2; 95% CI 1.03-1.2; p = 0.005, respectively). The two models controlled for important confounders such as diabetes mellitus and the year of delivery, in order to control for ascertainment bias.
Family history of diabetes mellitus has a significant, independent association with the risk for macrosomia and CD during pregnancy, regardless the presence of the disease.
检验糖尿病家族史与出生体重以及根据疾病存在情况分层的分娩方式之间的关联。
开展一项基于人群的研究，比较有和没有糖尿病家族史患者的出生结局。分析中排除了未接受产前护理的患者。使用多元逻辑回归模型控制混杂因素。采用Mantel-Haenszel方法在控制糖尿病（妊娠期或孕前糖尿病）存在的情况下获得加权比值比。
在181,479例分娩中，7.6%（n = 13,813）为有糖尿病家族史的患者。与没有糖尿病家族史的患者相比，这些患者的糖尿病（妊娠期或孕前糖尿病）发生率更高（13.7%对6.3%，OR = 2.3；95%CI 2.2 - 2.5，p < 0.001）。有糖尿病家族史的患者巨大儿发生率更高（出生体重>4 kg；5.7%对4.6%，p < 0.001）。此外，与对照组相比，有糖尿病家族史的患者剖宫产（CD）风险增加了1.3倍（17.1%对13.8%，p < 0.001）。使用两种不同的多元逻辑回归模型，一种以CD为结局变量，另一种以巨大儿为结局变量，糖尿病家族史与这些并发症之间的关联仍然显著（OR = 1.2；95%CI 1.1 - 1.2；p < 0.001和OR = 1.2；95%CI 1.03 - 1.2；p = 0.005）。这两个模型控制了重要的混杂因素，如糖尿病和分娩年份，以控制确定偏倚。
糖尿病家族史与孕期巨大儿风险和剖宫产风险存在显著的独立关联，无论疾病是否存在。
