Hospital de Clínicas de Porto Alegre, Serviço de Endocrinologia e Metabologia, Porto Alegre, RS, Brasil; Universidade Federal do Rio Grande do Sul, Programa de Pós-graduação em Ciências Médicas: Endocrinologia, Porto Alegre, RS, Brasil,
Hospital Nossa Senhora da Conceição, Serviço de Endocrinologia, Porto Alegre, RS, Brasil.
Arch Endocrinol Metab. 2023 May 25;67(5):e000628. doi: 10.20945/2359-3997000000628.
Pregnancy complicated by type 2 diabetes is rising, while data on type 2 diabetes first diagnosed in pregnancy (overt diabetes) are scarce. We aimed to describe the frequency and characteristics of pregnant women with overt diabetes, compare them to those with known pregestational diabetes, and evaluate the potential predictors for the diagnosis of overt diabetes.
A retrospective cohort study including all pregnant women with type 2 diabetes evaluated in two public hospitals in Porto Alegre, Brazil, from May 20, 2005, to June 30, 2021. Classic and obstetric factors associated with type 2 diabetes risk were compared between the two groups, using machine learning techniques and multivariable analysis with Poisson regression.
Overt diabetes occurred in 33% (95% confidence interval: 29%-37%) of 646 women. Characteristics of women with known or unknown type 2 diabetes were similar; excessive weight was the most common risk factor, affecting ~90% of women. Age >30 years and positive family history of diabetes were inversely related to a diagnosis of overt diabetes, while previous delivery of a macrosomic baby behaved as a risk factor in younger multiparous women; previous gestational diabetes and chronic hypertension were not relevant risk factors.
Characteristics of women with overt diabetes are similar to those of women with pregestational diabetes. Classic risk factors for diabetes not included in current questionnaires can help identify women at risk of type 2 diabetes before they become pregnant.
妊娠合并 2 型糖尿病的发病率正在上升，而关于妊娠期间首次诊断的 2 型糖尿病（显性糖尿病）的数据却很少。我们旨在描述显性糖尿病孕妇的频率和特征，将其与已知的孕前糖尿病孕妇进行比较，并评估显性糖尿病诊断的潜在预测因素。
这是一项回顾性队列研究，纳入了 2005 年 5 月 20 日至 2021 年 6 月 30 日期间在巴西阿雷格里港的两家公立医院就诊的所有 2 型糖尿病孕妇。使用机器学习技术和多元 Poisson 回归分析比较两组之间与 2 型糖尿病风险相关的经典和产科因素。
在 646 例孕妇中，33%（95%置信区间：29%-37%）发生了显性糖尿病。有已知或未知 2 型糖尿病的孕妇的特征相似；超重是最常见的危险因素，约影响 90%的孕妇。年龄>30 岁和糖尿病家族史阳性与显性糖尿病诊断呈负相关，而年轻多产妇中曾分娩巨大儿则为危险因素；既往妊娠期糖尿病和慢性高血压不是相关的危险因素。
显性糖尿病孕妇的特征与孕前糖尿病孕妇相似。当前问卷中未包括的糖尿病经典危险因素有助于在孕妇怀孕前识别出有患 2 型糖尿病风险的女性。
