期刊
DIABETOLOGIA
卷 64, 期 3, 页码 491-503出版社
SPRINGER
DOI: 10.1007/s00125-020-05343-w
关键词
Diabetes; Gestational hypertension; Hypertensive disorders of pregnancy; Meta-analysis; Pre-eclampsia; Systematic review
资金
- Diabetes Investigator Award from Diabetes Canada
The study found that a history of hypertensive disorders of pregnancy (HDP), including gestational hypertension and pre-eclampsia, is significantly associated with an increased risk of developing diabetes later on. Studies that adjusted for gestational diabetes mellitus also showed a persistent association between HDP and diabetes. Further research is needed to develop evidence-based screening and prevention strategies for diabetes risk prediction related to HDP.
Aims/hypothesis The association between a history of hypertensive disorders of pregnancy (HDP) and subsequent type 2 diabetes (referred to throughout as diabetes) remains inconclusive. We reviewed the most recent evidence to quantify the association of previous HDP with incident diabetes. Methods A systematic search of MEDLINE, Embase and CINAHL was performed up to 17 February 2020 to identify observational studies of the association between HDP (pre-eclampsia or gestational hypertension) and incident diabetes. Studies of women with pre-pregnancy diabetes were excluded. Two independent reviewers screened citations and abstracted results. Study quality was assessed in duplicate using the Newcastle-Ottawa Scale. Random-effects models were used to pool effect estimates. Heterogeneity was assessed using the I-2 statistic. Results After screening 4617 citations, 16 cohort studies with a total of 3,095,457 participants were included (unspecified HDP n = 5, pre-eclampsia only n = 4, gestational hypertension and pre-eclampsia n = 7). Risks of subsequent diabetes were significantly higher in women with a history of any HDP (HDP: adjusted hazard ratio [aHR] 2.24, 95% CI 1.95, 2.58; gestational hypertension: aHR 2.19 [95% CI 1.69, 2.84]; pre-eclampsia: aHR 2.56 [95% CI 2.02, 3.24]; preterm pre-eclampsia: aHR 3.05 [95% CI 2.05, 4.56]). The association between HDP and diabetes persisted in studies that adjusted for gestational diabetes mellitus (aHR 2.01 [95% CI 1.77, 2.28]). Conclusions/interpretation HDP are independently associated with a higher risk of diabetes. Further study is needed to determine how HDP contribute to diabetes risk prediction to develop evidence-based screening and prevention strategies.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据