RT杂志文章A1 Echouffo Tcheugui, Justin B. A1 Guan, Jun A1 Fu, Longdi A1 Retnakaran, Ravi A1 Shah，JF JAMA Network Open JO JAMA Network Open YR 2022 DO 10.1001/jamanetworkopen.2022.43618 VO 5 IS 11 SP e2243618 OP e2243618 SN 2574狗万体育下载地址-3805越来越多的证据表明，妊娠期高血压疾病(GHTD)和妊娠期糖尿病(GD)均与心血管疾病(CVD)风险增加相关。然而，GHTD和GD的同时发生在多大程度上与CVD风险相关仍然是未知的。评估GHTD和GD与CVD的个体和联合相关性。这项基于人群的队列研究使用了加拿大安大略省卫生和长期护理部卫生保健管理数据库。安大略所有在2007年7月1日至2018年3月31日期间被诊断为GHTD和/或GD的女性都被考虑纳入研究。排除了患有孕前糖尿病、高血压或心血管疾病的妇女。统计分析时间为2021年11月至2022年9月。GD和/或GHTD，使用诊断编码定义。GHTD和GD与CVD的个体和联合相关性(包括心肌梗死、急性冠状动脉综合征、卒中、冠状动脉搭桥术、经皮冠状动脉介入治疗或颈动脉内膜剥脱)，使用Cox回归模型评估，并调整相关的心脏代谢危险因素。随访时间从指标妊娠期延长至2020年3月31日。在886 295名符合条件的女性(平均[SD]年龄，30[5.6]岁;43 861例[4.9%]为孤立性GHTD, 54 061例[6.1%]为孤立性GD, 4975例[0.6%]为GHTD和GD)，在12年的随访中发生了1999例CVD事件。 In the early postpartum phase (first 5 years post partum), there was no association of co-occurrence of GTHD and GD (adjusted hazard ratio [aHR], 1.42, 95% CI, 0.78-2.58) or GD alone (aHR, 0.80; 95% CI, 0.60-1.06) with CVD; there was an association between isolated GTHD and incident CVD compared with no GTHD and no GD (aHR, 1.90; 95% CI, 1.51-2.35). In the late postpartum period (after the initial 5 years post partum), compared with no GD and no GHTD, isolated GHTD (aHR, 1.41, 95% CI, 1.12-1.76) and co-occurrence of GHTD and GD (aHR, 2.43, 95% CI, 1.60-3.67) were each associated with a higher risk of incident CVD. There was no association between isolated GD and incident CVD.In this cohort study, GHTD was associated with a high risk of CVD post partum, and the co-occurrence of GD and GHTD was associated with a much greater postpartum CVD risk. These findings suggest that CVD preventive care is particularly needed in the aftermath of combined GD and GHTD. RD 4/5/2023 UL https://doi.org/10.1001/jamanetworkopen.2022.43618

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