Abstract
Objective
To examine the association between glucose level in the high quartiles of the normal range during pregnancy and the development of subsequent long-term maternal atherosclerotic morbidity.
Study Design
A case-control study was conducted including women who delivered between the years 2000-2012 and subsequently develop atherosclerotic morbidity (n=815); the controls were matched for age and year of delivery (n=6065). The atherosclerotic l morbidity group was further divided to major event (cardiovascular, cerebrovascular disease, chronic renal failure), and cardiac procedures (such as coronary angiography). The mean follow-up duration for atherosclerotic disease was 74 months. The glucose levels during pregnancy were sorted by ≤ 60 mg/dl; 61-80 mg/dl, 81-100 mg/dl and glucose > 100 mg/dl. The chi-square test for trends was used to determine the association between glucose level during pregnancy and long-term maternal atherosclerotic complications. Kaplan-Meier survival curves and Cox proportional hazards models were used.
Results
A significant linear association was documented between glucose level during pregnancy and the long-term maternal atherosclerotic morbidity (Table). Glucose levels in the high quartiles had a significantly higher cumulative incidence of atherosclerotic hospitalizations Kaplan-Meier survival curve (P<0.001; Figure). Nevertheless, in a Cox proportional hazard model, adjusted for confounders such as gestational diabetes mellitus (GDM), preeclampsia and obesity, no significant association was noted between glucose levels during pregnancy and long-term maternal atherosclerotic hospitalizations (adjusted HR, 1.1; 95% CI, 0.9-1.1; P=0.167).
Conclusion
After controlling for GDM, glucose level in the high quartiles of the normal range during pregnancy per se is not an independent risk factor for long-term maternal atherosclerotic morbidity.
To examine the association between glucose level in the high quartiles of the normal range during pregnancy and the development of subsequent long-term maternal atherosclerotic morbidity.
Study Design
A case-control study was conducted including women who delivered between the years 2000-2012 and subsequently develop atherosclerotic morbidity (n=815); the controls were matched for age and year of delivery (n=6065). The atherosclerotic l morbidity group was further divided to major event (cardiovascular, cerebrovascular disease, chronic renal failure), and cardiac procedures (such as coronary angiography). The mean follow-up duration for atherosclerotic disease was 74 months. The glucose levels during pregnancy were sorted by ≤ 60 mg/dl; 61-80 mg/dl, 81-100 mg/dl and glucose > 100 mg/dl. The chi-square test for trends was used to determine the association between glucose level during pregnancy and long-term maternal atherosclerotic complications. Kaplan-Meier survival curves and Cox proportional hazards models were used.
Results
A significant linear association was documented between glucose level during pregnancy and the long-term maternal atherosclerotic morbidity (Table). Glucose levels in the high quartiles had a significantly higher cumulative incidence of atherosclerotic hospitalizations Kaplan-Meier survival curve (P<0.001; Figure). Nevertheless, in a Cox proportional hazard model, adjusted for confounders such as gestational diabetes mellitus (GDM), preeclampsia and obesity, no significant association was noted between glucose levels during pregnancy and long-term maternal atherosclerotic hospitalizations (adjusted HR, 1.1; 95% CI, 0.9-1.1; P=0.167).
Conclusion
After controlling for GDM, glucose level in the high quartiles of the normal range during pregnancy per se is not an independent risk factor for long-term maternal atherosclerotic morbidity.
| Original language | English |
|---|---|
| Pages (from-to) | S171 |
| Journal | American Journal of Obstetrics and Gynecology |
| Volume | 210 |
| Issue number | 1 |
| DOIs | |
| State | Published - 31 Jan 2014 |