Precision stratification of prognostic risk factors associated with outcomes in gestational diabetes mellitus: a systematic review.
Precision stratification of prognostic risk factors associated with outcomes in gestational diabetes mellitus: a systematic review.
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DOI：
10.1038/s43856-023-00427-1
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发表时间：
2024-01-12
期刊：
影响因子：
--
通讯作者：
Perng, Wei
中科院分区：
文献类型：
--
作者：
Semnani-Azad, Zhila;Gaillard, Romy;Hughes, Alice E;Boyle, Kristen E;Tobias, Deirdre K;Perng, Wei
本系统评价的目的是确定受妊娠期糖尿病（GDM）影响的女性及其后代的预后因素，重点关注女性的心血管疾病（CVD）和2型糖尿病（T2 D）终点以及后代的心脏代谢特征。该综述包括1990年1月1日至2021年9月30日期间以英语发表的研究，这些研究侧重于上述关注的结果，包括社会人口学因素，生活方式和行为特征，传统临床特征以及围产期/产后期间和整个生命过程中母亲和后代的组学生物标志物。未报告GDM暴露妇女或儿童中预后因素与关注结果相关性的研究被排除。在这里，我们确定了109篇出版物，包括98项观察性研究和11项随机对照试验。研究结果表明，GDM的严重程度，母亲肥胖，种族/民族，不健康的饮食和体力活动水平预测T2 D和CVD的妇女，和更大的心脏代谢风险的后代。然而，使用加拿大糖尿病2018年临床实践指南进行研究，由于潜在的混淆、反向因果关系和选择偏倚，证据水平较低。严重程度更高的GDM妊娠，以及伴有母体肥胖、不健康饮食和低体力活动的妊娠，以及发生在少数种族/民族女性中的病例，与母亲和后代的心脏代谢预后较差相关。然而，由于证据质量较低，需要进行前瞻性研究，收集详细的协变量数据，并进行高保真的随访。妊娠期糖尿病（GDM）是指妊娠期间血糖水平过高。我们试图确定与GDM妇女及其后代的短期和长期心脏代谢疾病风险、涉及心脏相关问题的健康状况和身体功能并发症相关的因素。我们回顾了与GDM女性中2型糖尿病（T2 D）和心血管疾病（CVD）风险相关的因素的出版物，并额外评估了GDM女性后代的身体成分。我们发现，GDM的严重程度、母亲肥胖、自我认定的种族/民族、不良饮食和低体力活动水平可预测女性产后T2 D和CVD，以及后代不利的长期心脏代谢疾病风险。证据的质量很差，强调需要进行高质量的研究，收集详细的短期和长期结果数据，以促进预防性干预措施，改善妇女和儿童的健康。Semnani-Azad et al.回顾了预测女性心血管疾病和2型糖尿病的预后因素的证据，以及妊娠期糖尿病后后代的心脏代谢特征。证据的质量很低，但一些母亲的特征预示着妇女及其后代的不利结果。
The objective of this systematic review is to identify prognostic factors among women and their offspring affected by gestational diabetes mellitus (GDM), focusing on endpoints of cardiovascular disease (CVD) and type 2 diabetes (T2D) for women, and cardiometabolic profile for offspring. This review included studies published in English language from January 1st, 1990, through September 30th, 2021, that focused on the above outcomes of interest with respect to sociodemographic factors, lifestyle and behavioral characteristics, traditional clinical traits, and ‘omics biomarkers in the mothers and offspring during the perinatal/postpartum periods and across the lifecourse. Studies that did not report associations of prognostic factors with outcomes of interest among GDM-exposed women or children were excluded. Here, we identified 109 publications comprising 98 observational studies and 11 randomized-controlled trials. Findings indicate that GDM severity, maternal obesity, race/ethnicity, and unhealthy diet and physical activity levels predict T2D and CVD in women, and greater cardiometabolic risk in offspring. However, using the Diabetes Canada 2018 Clinical Practice Guidelines for studies, the level of evidence was low due to potential for confounding, reverse causation, and selection biases. GDM pregnancies with greater severity, as well as those accompanied by maternal obesity, unhealthy diet, and low physical activity, as well as cases that occur among women who identify as racial/ethnic minorities are associated with worse cardiometabolic prognosis in mothers and offspring. However, given the low quality of evidence, prospective studies with detailed covariate data collection and high fidelity of follow-up are warranted. Gestational diabetes mellitus (GDM) occurs when levels of sugar in the blood are high during pregnancy. We sought to identify factors associated with short- and long-term cardiometabolic disease risk, health conditions that involve heart-related issues and complications in bodily function, among women with GDM and their offspring. We reviewed publications on factors related to type 2 diabetes (T2D) and cardiovascular disease (CVD) risk among women with GDM, and additionally assessed body composition in offspring of women with GDM. We found that GDM severity, maternal obesity, self-identified race/ethnicity, poor diet, and low physical activity levels predict postpartum T2D and CVD in the women, and unfavorable long-term cardiometabolic disease risk in offspring. The quality of evidence was poor, emphasizing a need for high-quality research capturing detailed short- and long-term outcome data to facilitate preventative interventions to improve health of women and children. Semnani-Azad et al. review the evidence on prognostic factors that predict cardiovascular disease and type 2 diabetes for women, and cardiometabolic profile in offspring subsequent to gestational diabetes. The evidence was of low quality, but some maternal characteristics were predictive of unfavourable outcomes in women and their offspring.
影响因子：
3.1
作者：
Eades CE;Styles M;Leese GP;Cheyne H;Evans JM
通讯作者：
Evans JM
影响因子：
8.2
作者：
Vandyousefi S;Davis JN;Gunderson EP
通讯作者：
Gunderson EP
既往患有妊娠期糖尿病的中国女性产后 2 型糖尿病发生风险列线图
影响因子：
3.2
作者：
Li W;Leng J;Liu H;Zhang S;Wang L;Hu G;Mi J
通讯作者：
Mi J