Harris Wellbeing Research Centre, University of Liverpool and Liverpool Women's Hospital, Members of Liverpool Health Partners, United Kingdom.
Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom.
Eur J Obstet Gynecol Reprod Biol. 2024 Oct;301:216-221. doi: 10.1016/j.ejogrb.2024.08.021. Epub 2024 Aug 13.
Cardiovascular disease is the leading cause of female death worldwide. The link between future cardiovascular events and a history of hypertensive disease in pregnancy or gestational diabetes (GDM) has been well established. Less well understood is the impact on future cardiovascular risk when gestational hypertension (GH) and GDM have occurred together. We assessed the association of GDM and GH with future cardiovascular events both alone and in combination.
All female patients discharged from French hospitals in 2013 with 5 years of subsequent and complete follow-up were identified. They were grouped depending on their history of GDM, history of GH, history of both or history of neither. After propensity score matching, patients with GDM and/or GH were matched 1:1 with patients with no GDM or GH. Hazard ratios (HR) for cardiovascular events during follow-up were adjusted by age at baseline.
Women with a history of GH had an increased risk of cardiovascular death (HR 5.46, 95 % confidence interval [CI] 1.93-15.49). Women with a history of GDM had no significant difference in the risk of cardiovascular events such as myocardial infarction (HR 0.88, 95 %CI 0.38-2.03) and cardiovascular death (HR 1.25, 95 %CI 0.47-3.36) during the 5 year follow up. Those with a history of both GDM and GH had a significantly increased risk of myocardial infarction (HR 23.33, 95 %CI 4.84-112.39).
Women with a history of both GH and GDM are at a 23-fold increased risk of myocardial infarction within the first 5 years of their postnatal lives.
心血管疾病是全球女性死亡的主要原因。未来心血管事件与妊娠高血压或妊娠期糖尿病（GDM）病史之间的联系已得到充分证实。但对于妊娠高血压（GH）和 GDM 同时发生对未来心血管风险的影响则了解较少。我们评估了 GDM 和 GH 单独和联合发生时与未来心血管事件的关联。
确定了 2013 年从法国医院出院且随后有 5 年完整随访记录的所有女性患者。根据她们的 GDM 病史、GH 病史、两者均有或两者均无的病史进行分组。在进行倾向评分匹配后，GDM 和/或 GH 患者与无 GDM 或 GH 的患者 1:1 匹配。根据基线时的年龄调整随访期间心血管事件的风险比（HR）。
有 GH 病史的女性心血管死亡风险增加（HR 5.46，95%置信区间 [CI] 1.93-15.49）。有 GDM 病史的女性在 5 年随访期间，心肌梗死（HR 0.88，95%CI 0.38-2.03）和心血管死亡（HR 1.25，95%CI 0.47-3.36）等心血管事件的风险无显著差异。同时患有 GDM 和 GH 的女性，心肌梗死的风险显著增加（HR 23.33，95%CI 4.84-112.39）。
在产后的头 5 年内，同时患有 GH 和 GDM 的女性发生心肌梗死的风险增加 23 倍。
