Macrosomia is a risk factor for incident maternal chronic kidney disease.
Adult
Body Mass Index
Diabetes, Gestational
/ diagnosis
Female
Fetal Macrosomia
/ diagnosis
Humans
Hypertension, Pregnancy-Induced
/ epidemiology
Incidence
Iran
/ epidemiology
Kidney Function Tests
/ methods
Maternal Age
Pregnancy
Pregnancy, High-Risk
Prenatal Care
/ methods
Renal Insufficiency, Chronic
/ diagnosis
Risk Assessment
/ methods
Risk Factors
Smoking
/ epidemiology
Chronic kidney disease
Gestational diabetes mellitus
Macrosomia
Journal
BMC pregnancy and childbirth
ISSN: 1471-2393
Titre abrégé: BMC Pregnancy Childbirth
Pays: England
ID NLM: 100967799
Informations de publication
Date de publication:
16 Mar 2021
16 Mar 2021
Historique:
received:
10
11
2020
accepted:
03
03
2021
entrez:
17
3
2021
pubmed:
18
3
2021
medline:
22
5
2021
Statut:
epublish
Résumé
Gestational diabetes mellitus (GDM) and macrosomia are associated with several adverse outcomes including diabetes mellitus and cardiovascular diseases, however, the relationship between GDM/macrosomia with incident chronic kidney disease (CKD) is a matter of debate. The purpose of this study was to examine the association between the history of macrosomia with or without GDM and incident maternal CKD. The study population includes 2669 women aged 18-50 years without known diabetes mellitus and CKD from participants of the Tehran Lipid and Glucose Study. The study population was categorized into 3 groups; group 1: GDM/macrosomia and without diabetes mellitus (n = 204), group 2: newly diagnosed incident diabetes mellitus (NDM) in the presence or abcence of GDM/Macrosomia (n = 113), and, group 3: the reference group including women without prior history of GDM/macrosomia and free of NDM (n = 2352). CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m During a median follow-up of 11.9 years, 613 incident CKD cases were identified. The multivariable hazard ratio (HR) and 95% confidence interval (CI) on GDM/macrosomia group was [1.32 (1.02-1.72)]; the risk was more prominent among non-hypertensive women [1.41 (1.07-1.85); P for interaction: 0.046]. Moreover, the history of macrosomia alone also showed a significant risk [1.36 (1.04-1.78)]; however, history of GDM alone did not have a significant risk [0.92 (0.34-2.46)]. Age, current smoking, eGFR, and SBP remained as independent risk factors for incident CKD. A history of GDM/macrosomia or macrosomia alone, independent of subsequent diabetes mellitus was associated with significant risk for incident maternal CKD. Pregnancy may provide a unique situation to identify high-risk women at risk for CKD that could benefit from regular monitoring of kidney function and providing risk modifying strategies.
Sections du résumé
BACKGROUND
BACKGROUND
Gestational diabetes mellitus (GDM) and macrosomia are associated with several adverse outcomes including diabetes mellitus and cardiovascular diseases, however, the relationship between GDM/macrosomia with incident chronic kidney disease (CKD) is a matter of debate. The purpose of this study was to examine the association between the history of macrosomia with or without GDM and incident maternal CKD.
METHODS
METHODS
The study population includes 2669 women aged 18-50 years without known diabetes mellitus and CKD from participants of the Tehran Lipid and Glucose Study. The study population was categorized into 3 groups; group 1: GDM/macrosomia and without diabetes mellitus (n = 204), group 2: newly diagnosed incident diabetes mellitus (NDM) in the presence or abcence of GDM/Macrosomia (n = 113), and, group 3: the reference group including women without prior history of GDM/macrosomia and free of NDM (n = 2352). CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m
RESULTS
RESULTS
During a median follow-up of 11.9 years, 613 incident CKD cases were identified. The multivariable hazard ratio (HR) and 95% confidence interval (CI) on GDM/macrosomia group was [1.32 (1.02-1.72)]; the risk was more prominent among non-hypertensive women [1.41 (1.07-1.85); P for interaction: 0.046]. Moreover, the history of macrosomia alone also showed a significant risk [1.36 (1.04-1.78)]; however, history of GDM alone did not have a significant risk [0.92 (0.34-2.46)]. Age, current smoking, eGFR, and SBP remained as independent risk factors for incident CKD.
CONCLUSIONS
CONCLUSIONS
A history of GDM/macrosomia or macrosomia alone, independent of subsequent diabetes mellitus was associated with significant risk for incident maternal CKD. Pregnancy may provide a unique situation to identify high-risk women at risk for CKD that could benefit from regular monitoring of kidney function and providing risk modifying strategies.
Identifiants
pubmed: 33726706
doi: 10.1186/s12884-021-03695-8
pii: 10.1186/s12884-021-03695-8
pmc: PMC7968264
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
210Références
Am J Cardiol. 2014 Apr 15;113(8):1364-70
pubmed: 24576544
J Am Coll Cardiol. 2017 Jul 4;70(1):1-25
pubmed: 28527533
Kidney Int. 2011 Dec;80(11):1231-8
pubmed: 21866089
Diabet Med. 2015 Feb;32(2):164-73
pubmed: 25407209
Br J Obstet Gynaecol. 1998 Dec;105(12):1279-87
pubmed: 9883919
J Clin Endocrinol Metab. 2005 Jul;90(7):3983-8
pubmed: 15840749
Arch Iran Med. 2010 May;13(3):243-4
pubmed: 20433230
PLoS One. 2016 Jul 06;11(7):e0158765
pubmed: 27383068
Diabetes Care. 2004 Jul;27(7):1721-7
pubmed: 15220253
Int J Public Health. 2014 Apr;59(2):231-41
pubmed: 24346180
J Clin Endocrinol Metab. 2015 Apr;100(4):1412-6
pubmed: 25668200
Acta Obstet Gynecol Scand. 1995 May;74(5):356-60
pubmed: 7778427
Diabetes Care. 2007 Jul;30 Suppl 2:S246-50
pubmed: 17596480
Br J Obstet Gynaecol. 1997 Feb;104(2):229-34
pubmed: 9070145
Pan Afr Med J. 2017 Feb 02;26:62
pubmed: 28451039
Obstet Gynecol. 2008 Oct;112(4):875-83
pubmed: 18827131
BJOG. 2018 Feb;125(3):336-341
pubmed: 28165208
Diabetes Care. 1998 Dec;21(12):2111-5
pubmed: 9839102
BMC Nephrol. 2014 Sep 17;15:152
pubmed: 25230678
Kidney Int. 2017 May;91(5):1224-1235
pubmed: 28187985
Pediatrics. 2003 Jun;111(6 Pt 1):1416-21
pubmed: 12777562
Am J Obstet Gynecol. 2005 Aug;193(2):332-46
pubmed: 16098852
Trials. 2009 Jan 25;10:5
pubmed: 19166627
J Clin Endocrinol Metab. 2010 Feb;95(2):772-8
pubmed: 19952227
Iran J Public Health. 2015 Aug;44(8):1036-44
pubmed: 26587467
Diabetes Care. 2010 Dec;33(12):2586-91
pubmed: 20807871
Curr Diab Rep. 2016 Jan;16(1):7
pubmed: 26742932
BMC Nephrol. 2016 Jul 13;17(1):82
pubmed: 27412615
BMC Public Health. 2009 Jan 31;9:44
pubmed: 19183493
Metabolism. 2005 Aug;54(8):1115-21
pubmed: 16092064
Diabetes Res Clin Pract. 2019 Sep;155:107811
pubmed: 31401151
J Clin Endocrinol Metab. 2015 Mar;100(3):1130-6
pubmed: 25559401
Prev Chronic Dis. 2013 Sep 19;10:E156
pubmed: 24050526
Lancet. 2020 Feb 29;395(10225):709-733
pubmed: 32061315
JAMA Netw Open. 2020 Feb 5;3(2):e1920964
pubmed: 32049292
Ann Intern Med. 2009 May 5;150(9):604-12
pubmed: 19414839
Multivariate Behav Res. 2011 May;46(3):399-424
pubmed: 21818162
Cardiovasc Diabetol. 2016 Jan 27;15:15
pubmed: 26817691
Arterioscler Thromb Vasc Biol. 2002 Dec 1;22(12):2066-71
pubmed: 12482836
Osteoporos Int. 2010 Dec;21(12):2067-74
pubmed: 20306023
Am J Kidney Dis. 2018 Jan;71(1):112-122
pubmed: 29128412
Diabetes Res Clin Pract. 2007 Aug;77(2):251-7
pubmed: 17234299
J Clin Transl Endocrinol. 2019 Feb 20;16:100185
pubmed: 30899673
Diabetes Care. 2008 Nov;31(11):2193-7
pubmed: 18697902
PLoS Med. 2018 Jan 16;15(1):e1002488
pubmed: 29337985
Diabet Med. 2017 Jan;34(1):69-78
pubmed: 26606421
Prev Med. 2016 Jan;82:99-104
pubmed: 26592692
PLoS One. 2012;7(9):e45304
pubmed: 23028919
Diabetes Care. 2018 Jul;41(7):1378-1384
pubmed: 29728364
Lancet. 1987 Jul 4;2(8549):3-9
pubmed: 2885513
Diabetes. 2006 Mar;55(3):792-7
pubmed: 16505245
Am Fam Physician. 2009 Jul 1;80(1):57-62
pubmed: 19621846
Diabetes Metab Res Rev. 2007 Feb;23(2):135-40
pubmed: 16770838