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曾分娩巨大儿的女性中,根据妊娠期葡萄糖耐量情况分层的代谢综合征未来发病风险:一项前瞻性队列研究。

Future risk of metabolic syndrome in women with a previous LGA delivery stratified by gestational glucose tolerance: a prospective cohort study.

机构信息

Department of Obstetrics and Gynecology, Kuopio University Hospital, Puijonlaaksontie 2, P.O.B 100, 70029 KYS, Kuopio, Finland.

Institute of Clinical Medicine, School of Medicine, University of Eastern Finland, P.O.B 1627, 70211, Kuopio, Finland.

出版信息

BMC Pregnancy Childbirth. 2018 Aug 10;18(1):326. doi: 10.1186/s12884-018-1958-z.

Abstract

BACKGROUND

Whether the delivery of a large-for-gestational-age (LGA) infant predicts future maternal metabolic syndrome (MetS) is not known. To this aim, we investigated the incidence of MetS and its components in women with or without a history of gestational diabetes mellitus (GDM) with a view to the birth weight of the offspring.

METHODS

Eight hundred seventy six women treated for their pregnancies in Kuopio University Hospital in 1989-2009 underwent a follow-up study (mean follow-up time 7.3 (SD 5.1) years), of whom 489 women with GDM and 385 normoglycemic controls. The women were stratified into two groups according to the newborn's birth weight: 10-90th percentile (appropriate-for-gestational-age; AGA) (n = 662) and > 90th percentile (LGA) (n = 116). MetS and its components were evaluated in the follow-up study according to the International Diabetes Federation criteria.

RESULTS

LGA vs. AGA delivery was associated with a higher incidence of MetS at follow-up in women with a background of GDM (54.4% vs. 43.6%), but not in women without GDM.

CONCLUSION

An LGA delivery in women with GDM is associated with a higher risk of future MetS and this group is optimal to study preventive measures for MetS. In contrast, an LGA delivery after a normoglycemic pregnancy was not associated with an increased future maternal MetS risk.

摘要

背景

巨大儿(LGA)分娩是否预示着未来的母亲代谢综合征(MetS)尚不清楚。为此,我们研究了患有或不患有妊娠糖尿病史(GDM)的妇女中代谢综合征及其成分的发生率,以期了解后代的出生体重。

方法

1989 年至 2009 年在库奥皮奥大学医院接受治疗的 876 名妇女进行了随访研究(平均随访时间为 7.3(SD 5.1)年),其中 489 名患有 GDM,385 名血糖正常对照。根据新生儿的出生体重,将妇女分为两组:10-90 百分位(适合胎龄;AGA)(n=662)和>90 百分位(LGA)(n=116)。根据国际糖尿病联合会的标准,在随访中评估代谢综合征及其成分。

结果

与 AGA 分娩相比,GDM 背景下的 LGA 分娩与随访时 MetS 发生率较高相关(54.4% vs. 43.6%),但在无 GDM 的妇女中则不然。

结论

患有 GDM 的妇女中 LGA 分娩与未来发生 MetS 的风险增加相关,该组是研究 MetS 预防措施的最佳选择。相比之下,在血糖正常的妊娠后 LGA 分娩与未来母亲发生 MetS 的风险增加无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/911f/6086077/56c9fc9e1bc8/12884_2018_1958_Fig1_HTML.jpg

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