Lee Joohyun, Ouh Yung-Taek, Ahn Ki Hoon, Hong Soon Cheol, Oh Min-Jeong, Kim Hai-Joong, Cho Geum Joon
Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea.
PLoS One. 2017 May 22;12(5):e0178150. doi: 10.1371/journal.pone.0178150. eCollection 2017.
Preeclampsia and gestational diabetes (GDM) have several mechanisms in common. The aim of this study was to determine whether women with preeclampsia have an increased risk of GDM in a subsequent pregnancy. Study data were collected from the Korea National Health Insurance Claims Database of the Health Insurance Review and Assessment Service for 2007-2012. Patients who had their first delivery in 2007 and a subsequent delivery between 2008 and 2012 in Korea were enrolled. A model of multivariate logistic regression analysis was performed with GDM as the final outcome to evaluate the risk of GDM in the second pregnancy. Among the 252,276 women who had their first delivery in 2007, 150,794 women had their second delivery between 2008 and 2012. On the multivariate regression analysis, women with preeclampsia alone in the first pregnancy had an increased risk of GDM in the second pregnancy when compared with women who had neither of these conditions in their first pregnancy (OR 1.2, 95% CI, 1.1-1.3). Women with GDM alone in the first pregnancy were at an increased risk for GDM in the second pregnancy (OR 3.3, 95% CI 3.1-3.4). The co-presence of preeclampsia and GDM in the first pregnancy further increased the risk of GDM in the second pregnancy (OR 5.9, 95% CI, 4.0-8.6). Our study showed that a history of preeclampsia may serve as an additional risk factor for GDM in a subsequent pregnancy.
子痫前期和妊娠期糖尿病(GDM)有多种共同机制。本研究的目的是确定子痫前期女性在后续妊娠中患GDM的风险是否增加。研究数据收集自2007 - 2012年健康保险审查和评估服务机构的韩国国民健康保险理赔数据库。纳入了2007年首次分娩且2008年至2012年在韩国有后续分娩的患者。以GDM作为最终结局进行多因素逻辑回归分析模型,以评估第二次妊娠中患GDM的风险。在2007年首次分娩的252,276名女性中,有150,794名女性在2008年至2012年进行了第二次分娩。多因素回归分析显示,与首次妊娠时既无子痫前期也无GDM的女性相比,首次妊娠时仅患子痫前期的女性在第二次妊娠时患GDM的风险增加(OR 1.2,95% CI,1.1 - 1.3)。首次妊娠时仅患GDM的女性在第二次妊娠时患GDM的风险增加(OR 3.3,95% CI 3.1 - 3.4)。首次妊娠时子痫前期和GDM并存会进一步增加第二次妊娠时患GDM的风险(OR 5.9,95% CI,4.0 - 8.6)。我们的研究表明,子痫前期病史可能是后续妊娠中GDM的一个额外风险因素。