Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan, 430030, Hubei, China.
MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Acta Diabetol. 2018 Jun;55(6):579-584. doi: 10.1007/s00592-018-1125-z. Epub 2018 Mar 15.
Epidemiological studies of the long-term maternal health outcomes of spontaneous miscarriages have been sparse and inconsistent. The objective of our study is to examine the association between spontaneous miscarriages and diabetes among middle-aged and older Chinese women.
A total of 19,539 women from the Dongfeng-Tongji cohort study who completed a questionnaire and had medical examinations performed on were included in the analysis. History of spontaneous miscarriage was obtained by self-reporting in the first follow-up questionnaire interview. The presence of diabetes was determined by a fasting plasma glucose level, self-reported physician diagnosis and use of antidiabetic medication. A series of multivariate logistic regression models were used to calculate the odds ratios and 95% CI across spontaneous miscarriage categories (0, 1, 2, ≥ 3) after adjustment for potential confounding factors.
The prevalence rate of diabetes was 18.8% among the participants. In the fully adjusted logistic regression model, women who had 1, 2 or ≥ 3 spontaneous miscarriages had 0.86 times (95% CI 0.68, 1.08), 1.30 times (95% CI 0.82, 2.04) and 2.11 times (95% CI 1.08, 4.11) higher risk of diabetes, respectively, compared with women who had no history of spontaneous miscarriage.
There is an increased risk of diabetes among women with a history of a higher number of spontaneous miscarriages. History of multiple spontaneous miscarriages should be taken into consideration when assessing the risk of diabetes.
自发性流产对中老年中国女性长期母婴健康结局影响的流行病学研究较为匮乏且结果不一致。本研究旨在探讨自发性流产与糖尿病之间的关系。
共纳入 19539 名参加东风-同济队列研究的女性，她们完成了问卷调查和体检。通过首次随访问卷访谈中的自我报告获取自发性流产史。糖尿病的存在通过空腹血糖水平、自我报告的医生诊断和使用降糖药物来确定。采用一系列多变量逻辑回归模型，在调整潜在混杂因素后，计算了自发性流产次数为 0、1、2 和≥3 次的个体发生糖尿病的比值比（OR）及其 95%置信区间（CI）。
参与者中糖尿病的患病率为 18.8%。在完全调整的逻辑回归模型中，与无自发性流产史的女性相比，有 1、2 次或≥3 次自发性流产史的女性发生糖尿病的风险分别高出 0.86 倍（95%CI 0.68，1.08）、1.30 倍（95%CI 0.82，2.04）和 2.11 倍（95%CI 1.08，4.11）。
有多次自发性流产史的女性发生糖尿病的风险增加。在评估糖尿病风险时，应考虑多次自发性流产史。
