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妊娠相关性高血压与子代心脏代谢健康。

Pregnancy-Associated Hypertension and Offspring Cardiometabolic Health.

机构信息

George Washington University Biostatistics Center, Washington, DC; and the Departments of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio, University of Utah Health Sciences Center, Salt Lake City, Utah, University of Texas Southwestern Medical Center, Dallas, Texas, Columbia University, New York, New York, Brown University, Providence, Rhode Island, University of Alabama at Birmingham, Birmingham, Alabama, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, MetroHealth Medical Center-Case Western Reserve University, Cleveland, Ohio, University of Texas Medical Branch, Galveston, Texas, Northwestern University, Chicago, Illinois, and University of Texas Health Science Center at Houston-Children's Memorial Hermann Hospital, Houston, Texas; and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.

出版信息

Obstet Gynecol. 2018 Feb;131(2):313-321. doi: 10.1097/AOG.0000000000002433.

Abstract

OBJECTIVE

To evaluate whether pregnancy-associated hypertension (gestational hypertension and preeclampsia) was associated with the cardiometabolic health of young offspring.

METHODS

This was a prospective observational follow-up study from 2012 to 2013 of children born to women previously enrolled in a mild gestational diabetes mellitus treatment trial or nongestational diabetes mellitus observational study. At 5-10 years after birth, children were examined and fasting blood samples obtained to determine the following cardiometabolic risk factors: blood pressure (BP), high-density lipoprotein cholesterol, triglycerides, glucose, homeostatic model assessment of insulin resistance, waist circumference, and body mass index (BMI).

RESULTS

This analysis included 979 children evaluated at a median 7 years of age. Twenty-three (2%) were born preterm from a hypertensive pregnancy, 73 (7%) were born at term from a hypertensive pregnancy, 58 (6%) were born preterm from a normotensive pregnancy, and 825 (84%) were born at term from a normotensive pregnancy (reference group). After adjusting for confounding factors, mean adjusted systolic BP was significantly higher in the children who were born at term to mothers who experienced pregnancy-associated hypertension compared with those born at term to normotensive mothers (systolic BP of 104 mm Hg, 95% CI 101-106 vs systolic BP of 99 mm Hg, 95% CI 99-100, P=.001). No other significant differences were observed.

CONCLUSION

Pregnancy-associated hypertension in women who deliver at term was associated with higher systolic BP in the offspring, but not with their measures of diastolic BP, BMI, waist circumference, homeostatic model assessment of insulin resistance, glucose, or lipids.

CLINICAL TRIAL REGISTRATION

ClinicalTrials.gov, NCT00069576.

摘要

目的

评估妊娠相关性高血压(妊娠期高血压和子痫前期)是否与后代的心脏代谢健康有关。

方法

这是一项从 2012 年到 2013 年对之前参加过轻度妊娠期糖尿病治疗试验或非妊娠期糖尿病观察性研究的女性所生子女进行的前瞻性观察性随访研究。在出生后 5-10 年,对儿童进行检查并采集空腹血样,以确定以下心脏代谢危险因素:血压(BP)、高密度脂蛋白胆固醇、甘油三酯、血糖、胰岛素抵抗稳态模型评估、腰围和体重指数(BMI)。

结果

这项分析包括 979 名在中位数为 7 岁时进行评估的儿童。23 名(2%)来自高血压妊娠的早产儿,73 名(7%)来自高血压妊娠的足月产儿,58 名(6%)来自正常血压妊娠的早产儿,825 名(84%)来自正常血压妊娠的足月产儿(参考组)。在调整混杂因素后,与来自正常血压母亲的足月产儿相比,来自高血压妊娠的足月产儿的儿童平均调整后的收缩压显著升高(收缩压为 104mmHg,95%CI 101-106 与收缩压为 99mmHg,95%CI 99-100,P=0.001)。没有观察到其他显著差异。

结论

在足月分娩的女性中,妊娠相关性高血压与后代的收缩压升高有关,但与舒张压、BMI、腰围、胰岛素抵抗稳态模型评估、血糖或脂质无关。

临床试验注册

ClinicalTrials.gov,NCT00069576。

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