Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, 5252 boul de Maisonneuve, H4A 3S5 Montreal, Quebec, Canada.
Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, 5252 boul de Maisonneuve, H4A 3S5 Montreal, Quebec, Canada; Department of Medicine, McGill University Health Center, 1001 DecarieBoulevard, H4A 3J1 Montreal, Quebec, Canada.
Pregnancy Hypertens. 2019 Apr;16:32-37. doi: 10.1016/j.preghy.2019.02.004. Epub 2019 Feb 18.
To evaluate the associations of a combined indicator of gestational diabetes mellitus (GDM) and gestational hypertension (GH) with diabetes and with hypertension in parental couples as a 'unit'.
Utilizing administrative health data, GH was identified in matched pairs (GDM vs. no GDM) of mothers with singleton live births (Quebec, Canada; cohort inception 1990-2007). Couples were categorized based on GDM/GH status s ('neither'; 'either'; or 'both'). Using validated administrative health database definitions, associations of this indicator with diabetes and with hypertension in both members of the couple (12 weeks postpartum to March 31, 2012) were evaluated through adjusted Cox proportional hazard models.
In 63,438 couples over a mean of 12.8 years (SD 5.4), diabetes risk was 9-fold higher (HR: 8.9; 95% CI 6.4, 12.2) in couples with either GDM/GH and 16-fold higher (HR 16.0; 95% CI 10.9, 23.5) in couples with both conditions compared to those with neither. Hypertension risk was 2-fold higher (HR: 1.8; 95% CI 1.5, 2.0) in couples either GDM/GH and 6-fold higher (HR 5.8; 95% CI 4.9, 7.0) in couples with both conditions compared to those with neither condition.
GDM/GH predict diabetes and hypertension in couples as a unit underscoring the concept of shared couple risk. These findings may help foster couple collaboration for cardiovascular risk reduction in the household.
评估妊娠糖尿病（GDM）和妊娠高血压（GH）联合指标与父母双方糖尿病和高血压的相关性，作为一个“单位”。
利用行政健康数据，在母亲患有单胎活产的匹配对子（GDM 与无 GDM）中（魁北克，加拿大；队列起始时间为 1990-2007 年），确定 GH。根据 GDM/GH 状况（“两者均无”；“两者均有”；“两者之一有”）对夫妇进行分类。使用经过验证的行政健康数据库定义，通过调整后的 Cox 比例风险模型评估该指标与夫妇双方糖尿病和高血压的相关性（产后 12 周至 2012 年 3 月 31 日）。
在 63438 对夫妇中，平均随访 12.8 年（标准差 5.4），与既无 GDM/GH 又无 GDM/GH 的夫妇相比，夫妇中任何一方有 GDM/GH 的糖尿病风险增加 9 倍（HR：8.9；95%CI：6.4，12.2），夫妇中两种情况都有的糖尿病风险增加 16 倍（HR：16.0；95%CI：10.9，23.5）。与既无 GDM/GH 又无 GDM/GH 的夫妇相比，夫妇中任何一方有 GDM/GH 的高血压风险增加 2 倍（HR：1.8；95%CI：1.5，2.0），夫妇中两种情况都有的高血压风险增加 6 倍（HR：5.8；95%CI：4.9，7.0）。
GDM/GH 可预测作为一个单位的夫妇中的糖尿病和高血压，突出了夫妇共同风险的概念。这些发现可能有助于促进夫妇合作，以减少家庭中的心血管风险。
