11 research outputs found
The Association of Family History of Premature Cardiovascular Disease or Diabetes Mellitus on the Occurrence of Gestational Hypertensive Disease and Diabetes
<div><p>Background</p><p>Gestational hypertensive diseases (GHD) and gestational diabetes mellitus (GDM) increase the risk of cardiovascular disease (CVD) later in life. However, the association between gestational medical diseases and familial history of CVD has not been investigated to date. In the present study, we examined the association between familial history of CVD and GHD or GDM via reliable questionnaires in a large cohort of registered nurses.</p><p>Methods</p><p>The Korean Nurses’ Survey was conducted through a web-based computer-assisted self-interview, which was developed through consultation with cardiologists, gynecologists, and statisticians. We enrolled a total of 9,989 female registered nurses who reliably answered the questionnaires including family history of premature CVD (FHpCVD), hypertension (FHH), and diabetes mellitus (FHDM) based on their medical knowledge. Either multivariable logistic regression analysis or generalized estimation equation was used to clarify the effect of positive family histories on GHD and GDM in subjects or at each repeated pregnancy in an individual.</p><p>Results</p><p>In this survey, 3,695 subjects had at least 1 pregnancy and 8,783 cumulative pregnancies. Among them, 247 interviewees (6.3%) experienced GHD and 120 (3.1%) experienced GDM. In a multivariable analysis adjusted for age, obstetric, and gynecologic variables, age at the first pregnancy over 35 years (adjusted OR 1.61, 95% CI 1.02–2.43) and FHpCVD (adjusted OR 1.60, 95% CI 1.16–2.22) were risk factors for GHD in individuals, whereas FHH was not. FHDM and history of infertility therapy were risk factors for GDM in individuals (adjusted OR 2.68, 95% CI 1.86–3.86; 1.84, 95% CI 1.05–3.23, respectively). In any repeated pregnancies in an individual, age at the current pregnancy and at the first pregnancy, and FHpCVD were risk factors for GHD, while age at the current pregnancy, history of infertility therapy, and FHDM were risk factors for GDM.</p><p>Conclusions</p><p>The FHpCVD and FHDM are significantly associated with GHD and GDM, respectively. Meticulous family histories should be obtained, and women with family histories of these conditions should be carefully monitored during pregnancy.</p></div
Pregnancy outcome after GHD or GDM at each parity (total 6,685 parity).
<p>Pregnancy outcome after GHD or GDM at each parity (total 6,685 parity).</p
Baseline characteristics of the study population.
<p>Baseline characteristics of the study population.</p
Distribution of the occurrence of GHD or GDM according to the order of pregnancy.
<p>(A) The x-axis denotes the order of pregnancy. The y-axis indicates the arbitrary numbers of subjects. Every number matches each patient with GHD. To better demonstrate the distribution of the occurrence of GHD, subjects with more occurrences and subjects with earlier occurrence were placed at lower arbitrary numbers. (B) A magnified graph from the dashed-line rectangle in (A). (C), (D) Similarly, distribution of the occurrence of GDM according to the order of pregnancy.</p
Familial history of cardiovascular risk factors and diseases.
<p>Familial history of cardiovascular risk factors and diseases.</p
Univariable and multivariable analysis of risk factors for GHD or GDM at each pregnancy (total 8,783 pregnancies).
<p>Univariable and multivariable analysis of risk factors for GHD or GDM at each pregnancy (total 8,783 pregnancies).</p
Univariable and multivariable analysis of risk factors for GHD or GDM at the first parity in subjects.
<p>Univariable and multivariable analysis of risk factors for GHD or GDM at the first parity in subjects.</p
Gravidity and parity of the study subjects.
<p>(A) Histogram of the number of gravidity in subjects with GHD or no GHD. (B) Histogram of the number of gravidity in subjects with GDM or no GDM. (C) Histogram of the number of parity in subjects with GHD or no GHD. (D) Histogram of the number of parity in subjects with GDM or no GDM.</p
Distribution of age at every repeated pregnancy and frequency of GHD or GDM according to the order of pregnancy.
<p>(A) Histogram of age at the pregnancy in subjects with GHD or no GHD. (B) Histogram of age at the pregnancy in subjects with GDM or no GDM. (C) Incidence of GHD according to the order of pregnancy. (D) Incidence of GDM according to the order of pregnancy.</p