加拿大曼尼托巴省原住民和其他人群中 2 型糖尿病妊娠的母婴结局：一项基于人群的研究。
Maternal and neonatal outcomes in pregnancies with type 2 diabetes in First Nation and other Manitoban people: a population-based study.
机构信息
Department of Internal Medicine (Yamamoto), University of Manitoba; Children's Hospital Research Institute of Manitoba (Yamamoto, Pylypjuk, Sellers, Wicklow); Departments of Obstetrics, Gynecology and Reproductive Sciences (Pylypjuk), and Pediatrics and Child Health (Sellers, Wicklow, Ruth), University of Manitoba; First Nations Health and Social Secretariat of Manitoba (McLeod); Manitoba Centre for Health Policy (Sirski, Prior, Ruth), University of Manitoba, Winnipeg, Man.
出版信息
CMAJ Open. 2022 Oct 23;10(4):E930-E936. doi: 10.9778/cmajo.20220025. Print 2022 Oct-Dec.
BACKGROUND
First Nation people living in Canada experience a high prevalence of type 2 diabetes in pregnancy. In this study, we aimed to describe maternal and neonatal outcomes in First Nation and all other females with type 2 diabetes living in Manitoba, Canada.
METHODS
This was a population-level retrospective cohort study using linked administrative data from Manitoba (2012-2017). We compared First Nation females with type 2 diabetes with all other Manitoban females with type 2 diabetes, using relative risks (RRs) and 95% confidence intervals (CIs).
RESULTS
A total of 2181 females with type 2 diabetes were included, and 1218 (55.8%) were First Nation. First Nation females with type 2 diabetes were significantly more likely to experience stillbirth (RR 2.14, 95% CI 1.11-4.13) and perinatal death (RR 2.39, 95% CI 1.37-4.17) than all other Manitoban females with type 2 diabetes. Offspring of First Nation females with type 2 diabetes had a higher risk of most neonatal complications than offspring of all other Manitoban females with type 2 diabetes, including a higher risk of congenital malformations (RR 1.97, 95% CI 1.30-2.99), but First Nation people did not have a higher risk of most maternal complications.
INTERPRETATION
First Nation pregnant individuals living with type 2 diabetes experienced a higher risk for adverse pregnancy outcomes than all other Manitoban females with type 2 diabetes. Additional studies are needed to identify both high-risk and protective factors for pregnancy complications in First Nation people living with type 2 diabetes in pregnancy.
背景
在加拿大，居住在原住民社区的人群 2 型糖尿病的发病率较高。本研究旨在描述加拿大马尼托巴省居住的原住民和所有其他 2 型糖尿病女性的母婴结局。
方法
这是一项基于人群的回顾性队列研究，使用了来自马尼托巴省（2012-2017 年）的行政关联数据。我们将原住民 2 型糖尿病女性与所有其他马尼托巴省 2 型糖尿病女性进行了比较，使用相对风险（RR）和 95%置信区间（CI）。
结果
共纳入 2181 例 2 型糖尿病女性，其中 1218 例（55.8%）为原住民。与所有其他马尼托巴省 2 型糖尿病女性相比，原住民 2 型糖尿病女性更易发生死胎（RR 2.14，95%CI 1.11-4.13）和围产期死亡（RR 2.39，95%CI 1.37-4.17）。与所有其他马尼托巴省 2 型糖尿病女性相比，原住民 2 型糖尿病女性的后代发生大多数新生儿并发症的风险更高，包括先天性畸形的风险更高（RR 1.97，95%CI 1.30-2.99），但原住民 2 型糖尿病女性的母婴并发症风险并不更高。
结论
与所有其他马尼托巴省 2 型糖尿病女性相比，居住在原住民社区的 2 型糖尿病孕妇母婴结局不良的风险更高。需要进一步研究以确定原住民 2 型糖尿病孕妇妊娠并发症的高危和保护因素。
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