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The Association of Family History of Premature Cardiovascular Disease or Diabetes Mellitus on the Occurrence of Gestational Hypertensive Disease and Diabetes.

The Association of Family History of Premature Cardiovascular Disease or Diabetes Mellitus on the Occurrence of Gestational Hypertensive Disease and Diabetes.
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Choi DJ, Yoon CH, Lee H, Ahn SY, Oh KJ, Park HY, Lee HY, Cho MC, Chung IM, Shin MS, Park SJ, Shim CY, Han SW, Chae IH,


Choi DJ, Yoon CH, Lee H, Ahn SY, Oh KJ, Park HY, Lee HY, Cho MC, Chung IM, Shin MS, Park SJ, Shim CY, Han SW, Chae IH, (click to view)

Choi DJ, Yoon CH, Lee H, Ahn SY, Oh KJ, Park HY, Lee HY, Cho MC, Chung IM, Shin MS, Park SJ, Shim CY, Han SW, Chae IH,

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PloS one 2016 12 0511(12) e0167528 doi 10.1371/journal.pone.0167528
Abstract
BACKGROUND
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.

METHODS
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.

RESULTS
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.

CONCLUSIONS
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.

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