Department of Obstetrics and Gynaecology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Clinical Epidemiology and Biostatistics, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
BJOG. 2023 Sep;130(10):1209-1216. doi: 10.1111/1471-0528.17454. Epub 2023 Mar 27.
Pre-eclampsia and gestational diabetes mellitus (GDM) are two common pregnancy complications that affect birth outcomes and are associated with a long-term risk of cardiovascular disease (CVD). The aims of this study were to investigate if the pre-eclampsia association with CVD is independent of GDM and modified by body mass index (BMI) or GDM.
Case-control study.
Sweden.
Cases were women with a first CVD event between 1991 and 2008 and a previous pregnancy who were matched with controls without CVD (1:5) by year of birth, age and region of birth.
Conditional logistic regression was used to evaluate the associations of GDM, pre-eclampsia and maternal BMI with CVD adjusted for potential confounders and effect modifications with interaction tests.
CVD.
There were 2639 cases and 13 310 controls with complete data. Pre-eclampsia and GDM were independent risk factors for CVD (adjusted odds ratio [aOR] 2.59, 95% CI 2.12-3.17 and aOR 1.47, 95% CI 1.04-2.09, respectively). After stratifying by maternal BMI, the adjusted association of pre-eclampsia with CVD did not differ notably between BMI groups: normal weight (aOR 2.65, 95% CI 1.90-3.69), overweight (aOR 2.67, 95% CI 1.52-4.68) and obesity (aOR 3.03, 95% CI 0.74-12.4). Similar findings were seen when stratifying on GDM/non-GDM.
Pre-eclampsia and GDM are independent risk factors for later CVD and having both during pregnancy is a major risk factor for later CVD. The association between pre-eclampsia and CVD is not modified by BMI. Effective CVD preventive programs for high-risk women are urgently needed in order to improve women's long-term health.
子痫前期和妊娠期糖尿病（GDM）是两种常见的妊娠并发症，它们会影响分娩结局，并与心血管疾病（CVD）的长期风险相关。本研究旨在探讨子痫前期与 CVD 的相关性是否独立于 GDM，并受体重指数（BMI）或 GDM 的影响。
病例对照研究。
瑞典。
病例为 1991 年至 2008 年间首次发生 CVD 事件且有既往妊娠的女性，并按出生年份、年龄和出生地与无 CVD 的对照组（1:5）相匹配。
采用条件逻辑回归分析 GDM、子痫前期和产妇 BMI 与 CVD 的相关性，调整潜在混杂因素，并通过交互检验评估效应修饰。
CVD。
共纳入 2639 例病例和 13310 例对照，且均有完整数据。子痫前期和 GDM 是 CVD 的独立危险因素（调整后的比值比[aOR] 2.59，95%CI 2.12-3.17 和 aOR 1.47，95%CI 1.04-2.09）。在按产妇 BMI 分层后，子痫前期与 CVD 的相关性在 BMI 组之间无显著差异：正常体重（aOR 2.65，95%CI 1.90-3.69）、超重（aOR 2.67，95%CI 1.52-4.68）和肥胖（aOR 3.03，95%CI 0.74-12.4）。在 GDM/非 GDM 分层中也观察到类似的结果。
子痫前期和 GDM 是 CVD 的独立危险因素，妊娠期间同时存在这两种疾病是 CVD 的主要危险因素。子痫前期与 CVD 的相关性不受 BMI 的影响。迫切需要为高危女性制定有效的 CVD 预防计划，以改善女性的长期健康。
