Prevalence of Adverse Pregnancy Outcomes, by Maternal Diabetes Status at First and Second Deliveries, Massachusetts, 1998-2007.
Prevalence of Adverse Pregnancy Outcomes, by Maternal Diabetes Status at First and Second Deliveries, Massachusetts, 1998-2007.
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DOI：
10.5888/pcd12.150362
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发表时间：
2015-12-10
影响因子：
5.5
通讯作者：
England LJ
中科院分区：
文献类型：
--
作者：
Kim SY;Kotelchuck M;Wilson HG;Diop H;Shapiro-Mendoza CK;England LJ
了解妊娠期糖尿病患病率和糖尿病相关并发症的模式可以为慢性病预防工作提供信息。我们检查了单胎连续分娩妇女的糖尿病状况对不良生育结果的影响。我们使用了1998-2007年马萨诸塞州怀孕到早期生活纵向数据系统的数据，这是一个基于人群的分娩队列。我们把样品限制在第一次和第二次平价交货。我们根据妊娠期糖尿病(GDM)和慢性糖尿病(CDM)状态为两次分娩创建了8个糖尿病类别。不良结果包括胎龄过大(LGA)、巨大儿、早产和剖宫产。我们根据糖尿病状况计算了每种结果的患病率估计。我们确定了133,633名同时分娩第一胎和第二胎的妇女。与在任一孕期均无糖尿病的妇女相比，在任何孕期有GDM或CDM的妇女都增加了不良分娩结局的风险；在第一胎产中没有糖尿病的妇女和在第二胎中没有糖尿病的妇女中，不良结局的发生率更高(LGA[8.5%比15.1%]、巨大儿[9.7%比14.9%]、剖腹产[24.7%比31.3%]和早产[7.7%比12.9%])；在第1胎中GDM和第2胎中无糖尿病的孕妇中，第2胎的产次较高(LGA[12.3%比18.2%]、巨大儿[12.3%比17.2%]和剖宫产[27.0%比37.9%])。在两次连续怀孕中的一次妊娠期间患有GDM的妇女在未受影响的妊娠中不良结局的风险增加，无论受糖尿病影响的妊娠是在它之前还是之后。
Understanding patterns of diabetes prevalence and diabetes-related complications across pregnancies could inform chronic disease prevention efforts. We examined adverse birth outcomes by diabetes status among women with sequential, live singleton deliveries. We used data from the 1998–2007 Massachusetts Pregnancy to Early Life Longitudinal Data System, a population-based cohort of deliveries. We restricted the sample to sets of parity 1 and 2 deliveries. We created 8 diabetes categories using gestational diabetes mellitus (GDM) and chronic diabetes mellitus (CDM) status for the 2 deliveries. Adverse outcomes included large for gestational age (LGA), macrosomia, preterm birth, and cesarean delivery. We computed prevalence estimates for each outcome by diabetes status. We identified 133,633 women with both parity 1 and 2 deliveries. Compared with women who had no diabetes in either pregnancy, women with GDM or CDM during any pregnancy had increased risk for adverse birth outcomes; the prevalence of adverse outcomes was higher in parity 1 deliveries among women with no diabetes in parity 1 and GDM in parity 2 (for LGA [8.5% vs 15.1%], macrosomia [9.7% vs. 14.9%], cesarean delivery [24.7% vs 31.3%], and preterm birth [7.7% vs 12.9%]); and higher in parity 2 deliveries among those with GDM in parity 1 and no diabetes in parity 2 (for LGA [12.3% vs 18.2%], macrosomia [12.3% vs 17.2%], and cesarean delivery [27.0% vs 37.9%]). Women with GDM during one of 2 sequential pregnancies had elevated risk for adverse outcomes in the unaffected pregnancy, whether the diabetes-affected pregnancy preceded or followed it.