Study of Women, Infant feeding, and Type 2 diabetes mellitus after GDM pregnancy (SWIFT), a prospective cohort study: methodology and design
Study of Women, Infant feeding, and Type 2 diabetes mellitus after GDM pregnancy (SWIFT), a prospective cohort study: methodology and design
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DOI：
10.1186/1471-2458-11-952
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发表时间：
2011-12-23
影响因子：
4.5
通讯作者：
Selby, Joseph V.
中科院分区：
文献类型：
--
作者：
Gunderson, Erica P.;Matias, Susana L.;Selby, Joseph V.
背景：有妊娠期糖尿病（GDM）病史的妇女在分娩后5年内发生2型糖尿病的风险较高。哺乳期持续时间影响妊娠期糖尿病后发生2型糖尿病的证据是基于一项回顾性研究，该研究报告了零相关性。GDM妊娠后妇女、婴儿喂养和2型糖尿病的研究（SWIFT）是一项前瞻性队列研究，研究对象是北方加州Kaiser Permanente（KPNC）综合医疗保健系统内近期患有GDM的产后妇女。SWIFT的主要目标是评估与配方奶喂养相比，延长密集哺乳期是否能降低GDM女性2型糖尿病的2年发病率。该研究还检查了哺乳强度和持续时间是否对产后2年期间的血糖、胰岛素抵抗和肥胖有持续的有利影响。本报告描述了本研究的设计和方法，以获得临床，生化，人体测量，并在招聘和后续phases.Methods行为测量：SWIFT是一个前瞻性的，观察性队列研究，招募和以下超过1000名产后妇女诊断为妊娠期GDM在KPNC。该研究招募了产后6-9周（基线）的女性，这些女性已通过标准GDM标准诊断，年龄20-45岁，分娩了单胎，足月（大于或等于妊娠35周）活产，未使用影响葡萄糖耐量的药物，并且在未来2年内未计划再次怀孕或搬出该地区。在基线时没有2型糖尿病和其他严重医疗状况的参与者在分娩后的前2年内每年进行2型糖尿病筛查。招募工作于2008年9月开始，2011年12月结束。通过怀孕和产后早期的电话访谈、每月邮寄的自填问卷和家庭调查，（产后3-11个月），在6个月时进行电话访谈，每年进行一次75 g 2小时OGTT的亲自检查，获得人体测量结果，并完成自我和访谈者管理的问卷调查。这是第一个大型的前瞻性的，以社区为基础的研究，涉及一个种族和种族多样化的队列的妇女与最近的GDM，严格评估哺乳强度和持续时间，并检查他们的关系，以事件2型糖尿病，同时考虑到许多潜在的混杂因素，以前没有评估。
Background: Women with history of gestational diabetes mellitus (GDM) are at higher risk of developing type 2 diabetes within 5 years after delivery. Evidence that lactation duration influences incident type 2 diabetes after GDM pregnancy is based on one retrospective study reporting a null association. The Study of Women, Infant Feeding and Type 2 Diabetes after GDM pregnancy (SWIFT) is a prospective cohort study of postpartum women with recent GDM within the Kaiser Permanente Northern California (KPNC) integrated health care system. The primary goal of SWIFT is to assess whether prolonged, intensive lactation as compared to formula feeding reduces the 2-year incidence of type 2 diabetes mellitus among women with GDM. The study also examines whether lactation intensity and duration have persistent favorable effects on blood glucose, insulin resistance, and adiposity during the 2-year postpartum period. This report describes the design and methods implemented for this study to obtain the clinical, biochemical, anthropometric, and behavioral measurements during the recruitment and follow-up phases.Methods: SWIFT is a prospective, observational cohort study enrolling and following over 1, 000 postpartum women diagnosed with GDM during pregnancy within KPNC. The study enrolled women at 6-9 weeks postpartum (baseline) who had been diagnosed by standard GDM criteria, aged 20-45 years, delivered a singleton, term (greater than or equal to 35 weeks gestation) live birth, were not using medications affecting glucose tolerance, and not planning another pregnancy or moving out of the area within the next 2 years. Participants who are free of type 2 diabetes and other serious medical conditions at baseline are screened for type 2 diabetes annually within the first 2 years after delivery. Recruitment began in September 2008 and ends in December 2011. Data are being collected through pregnancy and early postpartum telephone interviews, self-administered monthly mailed questionnaires (3-11 months postpartum), a telephone interview at 6 months, and annual in-person examinations at which a 75 g 2-hour OGTT is conducted, anthropometric measurements are obtained, and self-and interviewer-administered questionnaires are completed.Discussion: This is the first, large prospective, community-based study involving a racially and ethnically diverse cohort of women with recent GDM that rigorously assesses lactation intensity and duration and examines their relationship to incident type 2 diabetes while accounting for numerous potential confounders not assessed previously.