Association of a woman's own birth weight with subsequent risk for gestational diabetes
Association of a woman's own birth weight with subsequent risk for gestational diabetes
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DOI：
10.1001/jama.287.19.2534
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发表时间：
2002-05-15
影响因子：
120.7
通讯作者：
Hamman, RF
中科院分区：
文献类型：
--
作者：
Innes, KE;Byers, TE;Hamman, RF
背景一些研究报道了胎儿生长减少与老年人2型糖尿病风险之间的联系，但胎儿生长指数与妊娠期糖尿病（GDM）之间的联系，妊娠期糖尿病是妊娠的主要并发症，也是2型糖尿病的强有力预测因素。目的验证孕妇自身胎儿生长与其日后发生GDM的风险呈负相关的假设。来自纽约州卫生部的关联出院和生命记录数据的对照研究。人群1994年至1998年期间在纽约州完成首次怀孕并出生在纽约州的健康妇女，每个妇女的首次怀孕记录与她自己出生的记录（1970-1985年）相关联。病例为440例有GDM记录的妇女。对照组为22 955其余妇女没有迹象GDM.Main结果测量一个女人自己的出生体重，单独和调整gestational age.Results出生体重显示了一个U形的关系，一个女人的风险GDM在她的第一次怀孕，与最高的风险与低和高出生体重。经胎龄校正的比值比（OR）为2.16（95%置信区间[CI]，1.04-4.50），出生体重小于2000 g，1.53（95% CI，1.03-2.27），出生体重大于或等于4000 g。调整潜在的混杂因素，特别是孕前体重指数和母亲糖尿病，使低出生体重的OR增加到4.23（95%CI，1.55-11.51），但将高出生体重的OR降至0.92（95%CI，0.54-1.57），出生体重与GDM风险之间存在强烈的剂量-反应反比关系（趋势校正P
Context Several studies have reported links between reduced fetal growth and subsequent risk for type 2 diabetes among older adults, but the association between indices of-fetal growth and gestational diabetes mellitus (GDM), a major complication of pregnancy and a strong predictor of type 2 diabetes, remains little explored.Objective To test the hypothesis that a woman's own fetal growth is inversely related to her later risk for GDM.Design and Setting Case-control study of linked hospital discharge and vital record data from the New York State Department of Health.Population Healthy women who completed their first pregnancies in New York State between 1994 and 1998 and who were also born in New York State, Records from each woman's first pregnancy were linked to those from her own birth (1970-1985). Cases were 440 women with a record of GDM. Controls were 22 955 remaining women with no indication of GDM.Main Outcome Measure A woman's own birth weight, alone and adjusted for gestational age.Results Birth weight showed a U-shaped relationship to a woman's risk of GDM in her first pregnancy, with the highest risks associated with low and high birth weights. Odds ratios (ORs) adjusted for gestational age were 2.16 (95% confidence interval [CI], 1.04-4.50) for birth weight of less than 2000 g and 1.53 (95% CI, 1.03-2.27) for a birth weight of 4000 g or more. Adjustment for potential confounding factors, particularly prepregnancy body mass index and maternal diabetes, increased the OR for low birth weight to 4.23 (95% CI, 1.55-11.51), but reduced the OR for high birth weight to 0.92 (95% CI, 0.54-1.57), leaving a strong inverse dose-response relationship between birth weight and risk of GDM (adjusted P for trend