Walter Eyal, Tsumi Erez, Wainstock Tamar, Spiegel Efrat, Sheiner Eyal
a Department of Ophthalmology, Faculty of Health Sciences , Soroka University Medical Center, Ben-Gurion University of the Negev , Be'er Sheva , Israel.
b Public Health , Ben-Gurion University of the Negev , Be'er Sheva , Israel.
J Matern Fetal Neonatal Med. 2019 Aug;32(15):2529-2538. doi: 10.1080/14767058.2018.1439918. Epub 2018 Feb 21.
To determine whether children born to mothers with gestational diabetes mellitus (GDM) are at increased risk to develop of pediatric ophthalmic morbidity.
In this population based cohort study, all deliveries between 1991 and 2014 were included. Congenital malformations, multiple gestations, and patients lacking prenatal care were excluded from analysis. Mothers were defined as either having no GDM, having diet-treated GDM, or medically treated GDM. Outcomes were defined as different ophthalmic morbidities of the offspring until the age of 18. Kaplan-Meier curves were used to compare the cumulative morbidity in each group, and a Cox proportional hazard model was used to control for possible confounders.
During the study period, 238,622 deliveries met the inclusion criteria, of those 4.0% (n = 9601) of mothers were diagnosed with GDM treated by diet, and an additional 1.0% (n = 2398) were diagnosed with GDM treated by medication. Offsprings of patients with GDM treated by medication had a higher cumulative incidence of ophthalmic morbidity when compared to the other groups (Kaplan-Meier log rank test p = .038). GDM treated by medication was found to be an independent risk factor for long-term ophthalmic morbidity, in a cox multivariable model (adjusted HR: 1.5, 95%CI: 1.05-2.1, p = .025).
Gestational diabetes mellitus treated by medication is associated with an increased risk for long-term pediatric ophthalmic morbidity.
确定患有妊娠期糖尿病（GDM）的母亲所生子女患小儿眼科疾病的风险是否增加。
在这项基于人群的队列研究中，纳入了1991年至2014年间的所有分娩病例。分析中排除了先天性畸形、多胎妊娠以及缺乏产前护理的患者。母亲被定义为无GDM、饮食治疗的GDM或药物治疗的GDM。结局定义为后代在18岁之前的不同眼科疾病。采用Kaplan-Meier曲线比较每组的累积发病率，并使用Cox比例风险模型控制可能的混杂因素。
在研究期间，238,622例分娩符合纳入标准，其中4.0%（n = 9601）的母亲被诊断为饮食治疗的GDM，另有1.0%（n = 2398）被诊断为药物治疗的GDM。与其他组相比，药物治疗的GDM患者的后代眼科疾病累积发病率更高（Kaplan-Meier对数秩检验p = 0.038）。在Cox多变量模型中，药物治疗的GDM被发现是长期眼科疾病的独立危险因素（调整后的HR：1.5，95%CI：1.05 - 2.1，p = 0.025）。
药物治疗的妊娠期糖尿病与小儿长期眼科疾病风险增加有关。
