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Am J Kidney Dis:孕妇糖尿病与后代泌尿系统先天畸形风险增加有关

2015-05-07 MedSci译 MedSci原创

肾脏和泌尿道(CAKUT)的先天性畸形是儿童慢性肾脏疾病的主要原因。目前关于孕期糖尿病(DM)与儿童CAKUT风险情况尚不明确。因此Dart AB等人进行了一项基于人群的病例对照研究探究该问题。该研究共纳入了945名CAKUT后代,按照孕妇年龄、后代性别、出生体重等配对了4725名后代作为对照组。CAKUT组有39 (4.1%)名孕妇是妊娠合并糖尿病,对照组该数据为111 (2.3%)名孕妇为妊娠

肾脏和泌尿道(CAKUT)的先天性畸形是儿童慢性肾脏疾病的主要原因。目前关于孕期糖尿病(DM)与儿童CAKUT风险情况尚不明确。因此Dart AB等人进行了一项基于人群的病例对照研究探究该问题。

该研究共纳入了945名CAKUT后代,按照孕妇年龄、后代性别、出生体重等配对了4725名后代作为对照组。CAKUT组有39 (4.1%)名孕妇是妊娠合并糖尿病,对照组该数据为111 (2.3%)名孕妇为妊娠合并糖尿病,(P = 0.002)。而妊娠期糖尿病方面,CAKUT组有40 (4.2%)名孕妇,对照组有157 (3.3%)名孕妇,(P = 0.002)。经过多变量逻辑回归模型分析得出,妊娠合并糖尿病与后代CAKUT的发生相关(OR, 1.67; 95% CI, 1.14-2.46),而妊娠期糖尿病与其无明显相关性(OR, 1.29; 95% CI, 0.90-1.85)。同时研究者发现胎儿的出生体重也与CAKUT的发生密切相关,无论是大于胎龄儿(LGA)还是小于胎龄儿(SGA)(LGA: OR, 1.34 [95% CI, 1.11-1.63]; SGA: OR, 1.59 [95% CI, 1.26-2.01])。

研究结果表明,妊娠合并糖尿病使其后代CAKUT风险增加。CAKUT和大于胎龄儿(LGA)之间的关系表明,血糖控制差或许会增加CAKUT发生风险。该研究提出对糖尿病育龄妇女筛查和干预是必要的,可以对后代慢性肾脏疾病的风险进行干预。但是该研究缺乏孕妇孕期血糖控制情况以及孕妇BMI情况等数据,是该研究的不足。

原始出处:

Dart AB, Ruth CA, Sellers EA, Au W, Dean HJ. Maternal Diabetes Mellitus and Congenital Anomalies of the Kidney and Urinary Tract (CAKUT) in the Child. Am J Kidney Dis. 2015. 65(5): 684-91.

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    2015-05-09 wushaoling
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    2015-05-09 gwc389
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    2015-05-08 huaxipanxing

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