Savitz David A, Danilack Valery A, Elston Beth, Lipkind Heather S
Am J Epidemiol. 2014 Jul 1;180(1):41-4. doi: 10.1093/aje/kwu118. Epub 2014 May 30.
Although pregnancy events predict the long-term risk of chronic disease, little is known about their short-term impact because of the rarity of clinical events. We examined hospital discharge diagnoses linked to birth certificate data in the year following delivery for 849,639 births during 1995-2004 in New York City, New York. Adjusted odds ratios characterized the relationship between pregnancy complications and subsequent hospitalization for cardiovascular disease, stroke, and diabetes. Gestational hypertension was related to heart failure (adjusted odds ratio = 2.6, 95% confidence interval: 1.5, 4.5). Preeclampsia was related to all of the outcomes considered except type 1 diabetes, with adjusted odds ratios ranging from 2.0 to 4.1. Gestational diabetes was strongly related to the risk of subsequent diabetes (for type 1 diabetes, adjusted odds ratio = 40.4, 95% confidence interval: 23.8, 68.5; for type 2 diabetes, adjusted odds ratio = 22.6, 95% confidence interval: 16.9, 30.4) but to no other outcomes. The relationship of pregnancy complications to future chronic disease is apparent as early as the year following delivery. Moreover, elucidating short-term clinical outcomes offers the potential for etiological insights into the relationship between pregnancy events and chronic disease over the life course.
尽管妊娠事件可预测慢性病的长期风险,但由于临床事件罕见,其短期影响鲜为人知。我们研究了1995年至2004年纽约市849,639例分娩后一年内与出生证明数据相关的医院出院诊断。调整后的比值比描述了妊娠并发症与随后因心血管疾病、中风和糖尿病住院之间的关系。妊娠期高血压与心力衰竭有关(调整后的比值比=2.6,95%置信区间:1.5,4.5)。先兆子痫与除1型糖尿病外的所有考虑结局有关,调整后的比值比在2.0至4.1之间。妊娠期糖尿病与随后患糖尿病的风险密切相关(对于1型糖尿病,调整后的比值比=40.4,95%置信区间:23.8,68.5;对于2型糖尿病,调整后的比值比=22.6,95%置信区间:16.9,30.4),但与其他结局无关。妊娠并发症与未来慢性病的关系早在分娩后的一年内就很明显。此外,阐明短期临床结局为深入了解妊娠事件与慢性病在整个生命过程中的关系提供了病因学方面的潜在见解。