| Titre : | Longitudinal Study of Prepregnancy Cardiometabolic Risk Factors and Subsequent Risk of Gestational Diabetes Mellitus : The CARDIA Study. (2010) |
| Auteurs : | Erica-P GUNDERSON ; JACOBS (David-Rjr) : USA. Division of Epidemiology and Community Health. School of Public Health. University of Minnesota. Minneapolis. MN. ; . JUANRAN FENG ; LEWIS (Cora-E) : USA. Division of Preventive Medicine. University of Alabama at Birmingham. Birmingham. AL. ; Charles-Pjr QUESENBERRY ; Stephen SIDNEY ; Division of Research Epidemiology and Prevention. Kaiser Permanente Northern California. Oakland. CA. USA |
| Type de document : | Article |
| Dans : | American journal of epidemiology (vol. 172, n° 10, 2010) |
| Pagination : | 1131-1143 |
| Langues: | Anglais |
| Mots-clés : | Obésité ; Evolution ; Facteur risque ; Grossesse ; Lipide ; Soins ; Femme ; Homme ; Femme enceinte ; Epidémiologie |
| Résumé : | [BDSP. Notice produite par INIST-CNRS R0xG8sDH. Diffusion soumise à autorisation]. This study examined prepregnancy cardiometabolic risk factors and gestational diabetes mellitus (GDM) in subsequent pregnancies. The authors selected 1,164 women without diabetes before pregnancy who delivered 1,809 live births between 5 consecutive examinations from 1985 to 2006 in the Coronary Artery Risk Development in Young Adults (CARDIA) Study. The authors measured prepregnancy cardiometabolic risk factors and performed multivariate repeated-measures logistic regression to compute the odds of GDM adjusted for race, age, parity, birth order, and other covariates. Impaired fasting glucose (100-125 vs.<90 mg/dL), elevated fasting insulin (>15-20 and>20 vs.<10 muU/mL), and low levels of high-density lipoprotein cholesterol (<40 vs.>50 mg/dL) before pregnancy were directly associated with GDM : The odds ratios=4.74 (95% confidence interval (CI) : 2.14,10.51) for fasting glucose, 2.19 (95% CI : 1.15,4.17) for middle insulin levels and 2.36 (95% CI : 1.20,4.63) for highest insulin levels, and 3.07 (95% CI : 1.62,5.84) for low levels of high-density lipoprotein cholesterol among women with a negative family history of diabetes ; all P<0.01. Among overweight women, 26.7% with 1 or more cardiometabolic risk factors developed GDM versus 7.4% with none. Metabolic impairment exists before GDM pregnancy in nondiabetic women. Interconceptual metabolic screening could be included in routine health assessments to identify high-risk women for GDM in a subsequent pregnancy and to potentially minimize fetal exposure to metabolic abnormalities that program future disease. |
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