Metabolic syndrome after pregnancies complicated by pre-eclampsia or small-for-gestational-age: a retrospective cohort
Metabolic syndrome after pregnancies complicated by pre-eclampsia or small-for-gestational-age: a retrospective cohort
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DOI：
10.1111/1471-0528.13117
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发表时间：
2015-12-01
影响因子：
5.8
通讯作者：
Spaanderman, M. E. A.
中科院分区：
文献类型：
--
作者：
Al-Nasiry, S.;Ghossein-Doha, C.;Spaanderman, M. E. A.
目的探讨妊娠合并子痫前期或小于胎龄儿（SGA）妇女代谢综合征的患病率，两种胎盘综合征的缩影设计一项回顾性队列研究设置荷兰单一三级孕产妇医学中心人口有先兆子痫病史但无SGA的妇女（n = 742）或妊娠合并正常血压SGA的妇女（n = 147）方法对1996~2010年10月在北京市妇产科医院分娩的妇女进行产后6个月以上的心血管代谢和心血管危险因素筛查。采用Logistic回归分析计算各组的比值比和校正比值比。调整了年龄，产妇身高，吸烟，奇偶校验，分娩和measurement.Main结果measuresPrevalence之间的间隔代谢syndrome. ResultsThe代谢综合征的患病率在我们的人口是两倍高的妇女有先兆子痫的历史（13.9%）相比，妇女有SGA的历史（7.6%）。有先兆子痫病史的妇女与SGA妇女相比，代谢综合征、空腹胰岛素、HOMA和微量白蛋白尿的计算比值比均较高。在校正以下混杂因素后，这种差异仍然存在：代谢综合征（校正比值比，aOR 2.11; 95%可信区间，95%CI 1.00 - 4.47）和高胰岛素血症（aOR 1.78; 95%CI 1.13 - 2.81）胰岛素抵抗（HOMA（IR）; aOR 1.80; 95%CI 1.14 - 2.86）。微量白蛋白尿（aOR 1.58; 95%CI 0.85 - 2.93）没有达到调整后的混淆factors.ConclusionsA先兆子痫的历史，而不是SGA，与代谢综合征的显着性水平，这表明它涉及到母体，而不是胎儿胎盘综合征的病因。
ObjectiveTo study the prevalence of metabolic syndrome in women after a pregnancy complicated by pre-eclampsia or small-for-gestational-age (SGA), both epitomes of placental syndrome.DesignA retrospective cohort study.SettingSingle tertiary centre for maternal medicine in the Netherlands.PopulationWomen with a history of pre-eclampsia in absence of SGA (n=742) or pregnancy complicated by normotensive SGA (n=147) between 1996 and 2010.MethodsWomen were routinely screened for underlying cardiometabolic and cardiovascular risk factors at least 6months postpartum. Logistic regression analysis was used to calculate the odds ratio and adjusted odds ratio for each group. Adjustments were made for age, maternal height, smoking, parity, and interval between delivery and measurement.Main outcome measuresPrevalence of the metabolic syndrome.ResultsThe prevalence of the metabolic syndrome in our population was two-fold higher for women with a history of pre-eclampsia (13.9%) compared with women with a history of SGA (7.6%). Calculated odds ratios for metabolic syndrome, fasting insulin, HOMA, and microalbuminuria were all higher for women with a history of pre-eclampsia compared with women with SGA. This difference persisted after adjustment for confounding factors: metabolic syndrome (adjusted odds ratio, aOR2.11; 95%confidence interval, 95% CI 1.00-4.47) and hyperinsulinaemia (aOR 1.78; 95%CI1.13-2.81) insulin resistance (HOMA(IR); aOR1.80; 95%CI1.14-2.86). Microalbuminuria (aOR1.58; 95%CI 0.85-2.93) did not reach the level of significance after adjustment for confounding factors.ConclusionsA history of pre-eclampsia, rather than SGA, was associated with metabolic syndrome, suggesting that it relates to maternal rather than fetal etiology of placental syndrome.