Rice Madeline Murguia, Landon Mark B, Varner Michael W, Casey Brian M, Reddy Uma M, Wapner Ronald J, Rouse Dwight J, Biggio Joseph R, Thorp John M, Chien Edward K, Saade George, Peaceman Alan M, Blackwell Sean C, VanDorsten J Peter
George Washington University Biostatistics Center, Washington, DC; the Departments of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio, the University of Utah Health Sciences Center, Salt Lake City, Utah, the University of Texas Southwestern Medical Center, Dallas, Texas, Columbia University, New York, New York, Brown University, Providence, Rhode Island, the University of Alabama at Birmingham, Birmingham, Alabama, the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, MetroHealth Medical Center-Case Western Reserve University, Cleveland, Ohio, the University of Texas Medical Branch, Galveston, Texas, Northwestern University, Chicago, Illinois, the University of Texas Health Science Center at Houston-Children's Memorial Hermann Hospital, Houston, Texas, and the Medical University of South Carolina, Charleston, South Carolina; and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.
Obstet Gynecol. 2016 Apr;127(4):771-779. doi: 10.1097/AOG.0000000000001353.
To evaluate whether pregnancy-associated hypertension (preeclampsia or gestational hypertension) among women with varying degrees of glucose intolerance during pregnancy is associated with maternal metabolic syndrome 5-10 years later.
This was an observational cohort study of women previously enrolled in a treatment trial of mild gestational diabetes mellitus or an observational study of lesser degrees of glucose intolerance evaluated 5-10 years after their index pregnancy. At follow-up, women underwent anthropometric and blood pressure measurements and analysis of fasting glucose and serum lipids.
A total of 825 women (47% of eligible women from the original study) were included in this analysis and evaluated at a median 7 years after their index pregnancy at a median age of 35 years. Overall, 239 (29%) had subsequent metabolic syndrome. The frequency of metabolic syndrome and its components was highest in the women who had pregnancy-associated hypertension and delivered preterm. After adjusting for confounding factors, pregnancy-associated hypertension in women who delivered preterm was associated with subsequent hypertension (130/85 mm Hg or greater; relative risk 3.06, 95% confidence interval [CI] 1.95-4.80, P<.001), high triglycerides (150 mg/dL or greater; relative risk 1.82, 95% CI 1.06-3.14, P=.03), and metabolic syndrome (per the American Heart Association and National Heart Lung and Blood Institute Scientific Statement; relative risk 1.78, 95% CI 1.14-2.78, P=.01) compared with women who remained normotensive throughout their index pregnancy and were delivered at term.
Women with varying degrees of glucose intolerance who experienced pregnancy-associated hypertension and then delivered preterm had a higher frequency of subsequent hypertension, high triglycerides, and metabolic syndrome 5-10 years later.
评估孕期不同程度糖耐量异常的女性发生的妊娠相关高血压（子痫前期或妊娠期高血压）是否与5至10年后的母体代谢综合征相关。
这是一项观察性队列研究，研究对象为先前参与轻度妊娠期糖尿病治疗试验的女性，或在其首次妊娠后5至10年进行评估的糖耐量异常程度较轻的观察性研究中的女性。在随访时，对女性进行人体测量和血压测量，并分析空腹血糖和血脂。
本分析共纳入825名女性（占原始研究符合条件女性的47%），在其首次妊娠后中位时间7年、中位年龄35岁时进行评估。总体而言，239名（29%）女性随后出现代谢综合征。代谢综合征及其组分的发生率在发生妊娠相关高血压并早产的女性中最高。在调整混杂因素后，早产女性的妊娠相关高血压与随后的高血压（收缩压/舒张压≥130/85 mmHg；相对风险3.06，95%置信区间[CI] 1.95 - 4.80，P <.001）、高甘油三酯（≥150 mg/dL；相对风险1.82，95% CI 1.06 - 3.14，P =.03）以及代谢综合征（根据美国心脏协会和美国国立心肺血液研究所科学声明；相对风险1.78，95% CI 1.14 - 2.78，P =.01）相关，而在首次妊娠期间血压一直正常且足月分娩的女性中则不然。
孕期不同程度糖耐量异常且发生妊娠相关高血压并早产的女性，在5至10年后发生后续高血压、高甘油三酯和代谢综合征的频率更高。
