目的:我们旨在总结现有文献中妊娠期糖尿病(GDM)及其代际心血管疾病(CVD)对母亲和后代分娩后的影响之间的关系。
方法:PubMed,Embase,WebofScience,和Scopus用于搜索1980年1月至2024年6月之间的出版物,数据提取和荟萃分析持续到2024年7月31日。基于预定义的PROSPERO协议,作为全文发表的研究,选择了英文期刊文章,报道了怀孕期间GDM的存在及其与分娩后任何CVD发展的关联。所有研究均使用纽卡斯尔-渥太华量表进行评估。使用随机效应荟萃分析汇总最大调整后的风险估计值,以评估GDM的风险比(RR)。以及分娩后母亲和后代心血管疾病的总体和亚型。
结果:荟萃分析基于38项研究,共有77,678,684名参与者。结果表明,母亲分娩后发生总体CVD的风险增加了46%(RR1.46,95%CI1.34-1.59),后代的风险增加了23%(1.23,1.05-1.45)。GDM并发妊娠后。我们的亚组分析显示,有GDM病史的母亲面临发展不同亚型CVD的各种风险(20%至2倍),包括脑血管疾病,冠状动脉疾病,心力衰竭,静脉血栓栓塞.
结论:这些发现强调了受GDM影响的母亲和后代发生各种心血管疾病的风险增加,强调即使出生后也要采取预防措施,以减轻这些人群的心血管疾病负担。
OBJECTIVE: We aimed to summarize the association between gestational diabetes mellitus (GDM) and its intergenerational cardiovascular diseases (CVDs) impacts in both mothers and
offspring post-delivery in existing literature.
METHODS: PubMed, Embase, Web of Science, and Scopus were utilized for searching publications between January 1980 and June 2024, with data extraction and meta-analysis continuing until 31 July 2024. Based on a predefined PROSPERO protocol, studies published as full-length, English-language journal articles that reported the presence of GDM during pregnancy and its association with any CVD development post-delivery were selected. All studies were evaluated using the Newcastle-Ottawa Scale. Maximally adjusted risk estimates were pooled using random-effects meta-analysis to assess the risk ratio (RR) of GDM, and overall and subtypes of CVDs in both mothers and
offspring post-delivery.
RESULTS: The meta-analysis was based on 38 studies with a total of 77,678,684 participants. The results showed a 46% increased risk (RR 1.46, 95% CI 1.34-1.59) for mothers and a 23% increased risk (1.23, 1.05-1.45) for
offspring of developing overall CVDs after delivery, following a GDM-complicated pregnancy. Our subgroup analysis revealed that mothers with a history of GDM faced various risks (20% to 2-fold) of developing different subtypes of CVDs, including cerebrovascular disease, coronary artery disease, heart failure, and venous thromboembolism.
CONCLUSIONS: These findings underscore the heightened risk of developing various CVDs for mothers and
offspring affected by GDM, emphasizing the importance of preventive measures even right after birth to mitigate the burden of CVDs in these populations.