College of Pharmacy and Health Sciences, Texas Southern University, Houston, TX 77004, USA.
Center of Excellence in Health Equity, Training, and Research, Baylor College of Medicine, Houston, TX 77030, USA.
J Public Health (Oxf). 2022 Aug 25;44(3):549-557. doi: 10.1093/pubmed/fdab117.
The prevalence of diabetes in pregnant women has increased in the USA over recent decades. The primary aim of this study was to assess the association between diabetes in pregnancy and maternal near-miss incident, maternal mortality and selected adverse foetal outcomes.
We conducted a retrospective, cross-sectional analysis among pregnancy-related hospitalizations in USA between 2002 and 2014. We examined the association between DM and GDM as exposures and maternal in-hospital mortality, maternal cardiac arrest, early onset of delivery, poor foetal growth and stillbirth as the outcome variables.
Among the 57.3 million pregnant women in the study population, the prevalence of GDM and DM was 5.4 and 1.3%, respectively. We found that pregnant women with DM were three times more likely to experience cardiac arrest (OR = 3.21; 95% CI = 2.57-4.01) and in-hospital maternal death (OR = 3.05; 95% CI = 2.45-3.79), as compared to those without DM. Among pregnant women with GDM and DM, the risk for early onset of delivery was higher, compared to women without GDM or DM.
A diagnosis of diabetes prior to pregnancy contributes significantly to the risk of maternal cardiac arrest, maternal mortality and adverse foetal outcomes.
近几十年来，美国孕妇糖尿病的患病率有所增加。本研究的主要目的是评估妊娠糖尿病（GDM）和糖尿病（DM）与孕产妇near-miss 事件、孕产妇死亡率和选定的不良胎儿结局之间的关系。
我们对 2002 年至 2014 年美国妊娠相关住院患者进行了回顾性、横断面分析。我们研究了 DM 和 GDM 作为暴露因素与孕产妇院内死亡率、孕产妇心脏骤停、早产、胎儿生长不良和死胎等结局变量之间的关系。
在研究人群的 5730 万孕妇中，GDM 和 DM 的患病率分别为 5.4%和 1.3%。我们发现，患有 DM 的孕妇发生心脏骤停（OR=3.21；95%CI=2.57-4.01）和院内孕产妇死亡（OR=3.05；95%CI=2.45-3.79）的风险是没有 DM 的孕妇的三倍。与没有 GDM 或 DM 的孕妇相比，患有 GDM 和 DM 的孕妇早产的风险更高。
在妊娠前诊断出糖尿病显著增加了孕产妇心脏骤停、孕产妇死亡率和不良胎儿结局的风险。
