Postpartum metabolic syndrome after gestational hypertension and preeclampsia, a prospective cohort study
Postpartum metabolic syndrome after gestational hypertension and preeclampsia, a prospective cohort study
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DOI：
10.1016/j.preghy.2019.08.088
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发表时间：
2019-10-01
影响因子：
2.2
通讯作者：
Farquhar, Carey
中科院分区：
文献类型：
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作者：
Osoti, Alfred O.;Page, Stephanie T.;Farquhar, Carey
目的：我们评估了产后6个月代谢综合征（MetS）的风险，MetS是未来心血管疾病（CVD）风险的标志，比较了最近妊娠合并妊娠期高血压（GH）或先兆子痫（PE）的妇女与血压正常的妇女。这是一项前瞻性队列研究，在肯尼亚内罗毕，分娩后前12周内积极招募GH或PE女性和血压正常女性。参与者接受了采访，血压和人体测量，包括在登记时和产后6个月获得的腰围。在产后6个月测量空腹血脂和血糖。采用Poisson分布的广义线性回归模型估计产后6个月MetS的粗相对危险度（RR）和调整后的RR（ARR），调整后的先验潜在混杂因素。妊娠合并GH或PE的妇女产后6个月MetS患病率（34.9%）高于血压正常的妇女（11.5%）。GH和PE与MetS的3倍或更高风险相关（ARR 3.01; 95%置信区间[CI] 1.58，5.71; p < 0.001），总体和5个组成部分中的3个，即高血压（ARR 3.01; 95%置信区间[CI] 1.58，5.71; p < 0.001）。35 [2.04，5.51]，p < 0.001），高胆红素血症（ARR 3.25 [1.16-9.10]，p = 0.01）和空腹高血糖（ARR 6.20 [1.07-35.76]，p = 0.03）。结论：在产后6个月，GH和PE与MetS的3倍或更高风险相关，尤其是高血压、空腹高血糖和空腹高血糖。
Objective: We evaluated the 6-month postpartum risk of metabolic syndrome (MetS), a marker of future cardiovascular disease (CVD) risk, comparing women whose most recent pregnancies were complicated with gestational hypertension (GH) or preeclampsia (PE) versus those who had normotensive pregnancies.Study design: This was a prospective cohort study in which women with GH or PE and normotensive women were actively enrolled during the first 12 weeks after delivery in Nairobi, Kenya. Participants were interviewed, blood pressures and anthropometric measurements including waist circumference obtained at enrollment and 6 months postpartum. Fasting lipid profile and plasma glucose were measured at 6 months postpartum. A generalized linear regression model with Poisson distribution was used to estimate crude relative risk (RR) of 6-month postpartum MetS and adjusted RR (ARR) after adjusting for apriori potential confounders.Results: Among 194 postpartum women, 63 (32%) had experienced GH or PE. Prevalence of MetS at 6 months postpartum was higher among women whose pregnancies were complicated with GH or PE (34.9%) compared to those who were normotensive (11.5%). GH and PE were associated with a 3-fold or greater risk of MetS (ARR) 3.01; 95% Confidence interval [CI] 1.58, 5.71; p < 0.001) overall and three of the five components, namely hypertension (ARR 3.]35 [2.04, 5.51], p < 0.001), hypertriglyceridemia (ARR 3.25 [1.16-9.10], p = 0.01), and fasting hyperglycemia (ARR 6.20 [1.07-35.76], p = 0.03), compared to having normal blood pressures during pregnancy.Conclusion: At 6 months postpartum, GH and PE were associated with three-fold or higher risk of MetS and especially hypertension, fasting hypertriglyceridemia, and fasting hyperglycemia.