Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden; Center for Primary Health Care Research, Lund University, Malmö, Sweden.
Center for Primary Health Care Research, Lund University, Malmö, Sweden.
Nutr Metab Cardiovasc Dis. 2023 Oct;33(10):2028-2034. doi: 10.1016/j.numecd.2023.06.008. Epub 2023 Jun 19.
Gestational diabetes is more common in many first-generation immigrant women in Europe and other Western countries. Less is known about second-generation immigrant women; such knowledge is needed to understand generational influences on diabetes risk. We aimed to study second-generation immigrant women regarding the presence of all types of diabetes during pregnancy.
A cohort study was conducted using the Swedish National Birth Register, the National Patient Register, and the Total Population Register. We used Cox regression analysis to compute hazard ratios (HRs) and 99% confidence intervals (99% CI) for any diabetes during pregnancy and specific subtypes (gestational diabetes, pre-existing diabetes type 1, pre-existing diabetes type 2) in second-generation immigrant women compared with Swedish-born women with two Swedish-born parents while adjusting for sociodemographic factors, family history of diabetes, body mass index, smoking habits, and comorbidities. The study population included a total of 989,986 deliveries and 17,938 diabetes cases. The fully adjusted HR (with 99% CI) for any type of diabetes during pregnancy among second-generation immigrant women was 1.11 (1.05-1.18). Higher risks were found in women with parents from Africa, Asia, or Eastern Europe, as well as Denmark. A lower risk for pre-existing type 1 diabetes was found overall and for women with parents from most geographic regions.
In this national cohort study, the risk of all types of diabetes during pregnancy was increased in second-generation immigrant women. Diabetes prevention and treatment is especially important in these women both before and during pregnancy.
在欧洲和其他西方国家，许多第一代移民女性中妊娠糖尿病更为常见。关于第二代移民女性，我们知之甚少；为了了解代际因素对糖尿病风险的影响，我们需要了解这方面的知识。我们旨在研究第二代移民女性在怀孕期间所有类型糖尿病的患病情况。
本研究采用了瑞典国家出生登记处、国家患者登记处和总人口登记处的数据进行队列研究。我们使用 Cox 回归分析计算了第二代移民女性与具有两位瑞典籍父母的瑞典籍女性相比，在调整了社会人口因素、糖尿病家族史、体重指数、吸烟习惯和合并症后，怀孕期间任何类型糖尿病（包括妊娠期糖尿病、原有 1 型糖尿病、原有 2 型糖尿病）的风险比（HR）和 99%置信区间（99%CI）。研究人群共包括 989986 例分娩和 17938 例糖尿病病例。第二代移民女性怀孕期间任何类型糖尿病的完全调整 HR（99%CI）为 1.11（1.05-1.18）。来自非洲、亚洲或东欧以及丹麦的女性风险更高。总体而言，以及来自大多数地理区域的女性，原有 1 型糖尿病的风险较低。
在这项全国性队列研究中，第二代移民女性在怀孕期间所有类型糖尿病的风险增加。这些女性在怀孕前后都需要特别注意糖尿病的预防和治疗。
