早发性子痫前期与产后代谢综合征的患病率。

Early-onset preeclampsia and the prevalence of postpartum metabolic syndrome.

机构信息

From the Department of Obstetrics and Gynecology, University Hospital Groningen, Radboud University Medical Center Nijmegen and University Hospital Maastricht, the Netherlands.

出版信息

Obstet Gynecol. 2009 Nov;114(5):1076-1084. doi: 10.1097/AOG.0b013e3181b7b242.

DOI:10.1097/AOG.0b013e3181b7b242

PMID:20168110

Abstract

OBJECTIVE

To determine the prevalence of the metabolic syndrome postpartum in women with a history of pregnancy complicated by early-onset vascular disorders compared with women with late-onset disorders.

METHODS

In this retrospective cohort study 849 women with a history of pregnancy complicated by vascular disorders (preeclampsia; gestational hypertension; hemolysis, elevated liver enzymes, low platelets syndrome; eclampsia; placental abruption; fetal growth restriction; and stillbirth as a result of placental insufficiency) were divided into early-onset (delivery before 32 weeks of gestation, n=376) and late-onset (delivery at or beyond 32 weeks, n=473). By use of four internationally accepted criteria to diagnose metabolic syndrome, we compared its prevalence in both groups using odds ratios (ORs), adjusted for maternal age, smoking, alcohol and coffee consumption, birth weight centile, stillbirth, and interval between delivery and measurements.

RESULTS

The metabolic syndrome was present in 15-25% of women after early-onset vascular-complicated pregnancy and in 10-14% of women after late-onset disease, depending on the criteria set used; adjusted OR 2.51 (95% confidence interval [CI] 1.66-3.80) using World Health Organization criteria; adjusted OR 2.01 (95% CI 1.37-2.96) using International Diabetes Federation criteria; adjusted OR 2.16 (95% CI 1.31-3.55) using Third Adult Treatment Panel (ATPIII) criteria; and adjusted OR 2.02 (95% CI 1.28-3.17) using Third Adult Treatment Panel updated criteria.

CONCLUSION

The prevalence of the metabolic syndrome postpartum is twice as high in women with a history of early-onset (delivery before 32 weeks) compared to late-onset vascular-complicated pregnancy (delivery at or beyond 32 weeks).

LEVEL OF EVIDENCE

II.

摘要

目的

比较早发型（<32 周分娩）与晚发型（≥32 周分娩）血管并发症孕妇产后代谢综合征的患病率。

方法

本回顾性队列研究纳入 849 例存在血管并发症史（子痫前期、妊娠期高血压、HELLP 综合征、子痫、胎盘早剥、胎儿生长受限、胎盘功能不全导致的死胎）的妊娠女性，根据分娩时间分为早发型（<32 周）376 例和晚发型（≥32 周）473 例。采用四项国际公认的代谢综合征诊断标准，通过比值比（OR）比较两组的代谢综合征患病率，同时校正母亲年龄、吸烟、饮酒、咖啡摄入、出生体重百分位数、死胎和分娩与测量之间的间隔。

结果

采用不同标准时，早发型血管并发症孕妇产后代谢综合征的患病率为 15%~~25%，晚发型为 10%~~14%；采用世界卫生组织（WHO）标准时调整 OR 为 2.51（95%CI 1.66-3.80）；采用国际糖尿病联盟（IDF）标准时为 2.01（95%CI 1.37-2.96）；采用美国成人第三版治疗指南（ATPIII）标准时为 2.16（95%CI 1.31-3.55）；采用美国成人第三版治疗指南更新标准时为 2.02（95%CI 1.28-3.17）。