scholarly journals Gestational Diabetes and Incident Heart Failure: A Cohort Study

2021 ◽  
Author(s):  
Justin B. Echouffo-Tcheugui ◽  
Jun Guan ◽  
Ravi Retnakaran ◽  
Baiju R Shah
Keyword(s):  
Heart Failure ◽  
Cohort Study ◽  
Gestational Diabetes ◽  
Post Partum ◽  
Administrative Databases ◽  
Secondary Outcome ◽  
Term Care ◽  
Index Pregnancy ◽  
Laboratory Test Results ◽  
Increased Risk

<b>Objective: </b>To assess whether gestational diabetes mellitus (GDM) is associated with an increased risk of heart failure (HF). <p><b>Research Design and Methods</b>: We conducted a population-based cohort study using information from the Ministry of Health and Long Term Care of Ontario (Canada) health-care administrative databases. We identified all women in Ontario with a GDM diagnosis with a livebirth singleton delivery between July 1, 2007 and March 31, 2018. Women with diabetes or HF before pregnancy were excluded. GDM was defined based on laboratory test results and diagnosis coding. The primary outcome was incident HF hospitalization, over a period extending from the index pregnancy until March 31, 2019. The secondary outcome was prevalent peripartum cardiomyopathy (PPCM) at index pregnancy. Estimates of association were adjusted for relevant cardiometabolic risk factors.</p> <p><b>Results</b>: Among 906,319 eligible women (mean age: 30 years [SD: 5.6], 50,193 with GDM [5.5%]), there were 763 HF events over a median 7 years. GDM was associated with a higher risk of incident HF (adjusted hazard ratio [aHR]: 1.62, 95% CI: 1.28, 2.05), compared to no-GDM. This association remained significant after accounting for chronic kidney disease, post-partum diabetes, hypertension, and coronary artery disease (aHR: 1.39, 95% CI: 1.09, 1.79). GDM increased the odds of PPCM (adjusted odds ratio: 1.83, 95% CI: 1.45, 2.33).</p> <p><b>Conclusions</b>: In a large observational study, GDM was associated with an increased risk of HF. Consequently, diabetes screening during pregnancy is suggested to identify women at risk of HF.</p> <br> <p> </p>

scholarly journals Gestational Diabetes and Incident Heart Failure: A Cohort Study

2021 ◽  
Author(s):  
Justin B. Echouffo-Tcheugui ◽  
Jun Guan ◽  
Ravi Retnakaran ◽  
Baiju R Shah
Keyword(s):  
Heart Failure ◽  
Cohort Study ◽  
Gestational Diabetes ◽  
Post Partum ◽  
Administrative Databases ◽  
Secondary Outcome ◽  
Term Care ◽  
Index Pregnancy ◽  
Laboratory Test Results ◽  
Increased Risk

<b>Objective: </b>To assess whether gestational diabetes mellitus (GDM) is associated with an increased risk of heart failure (HF). <p><b>Research Design and Methods</b>: We conducted a population-based cohort study using information from the Ministry of Health and Long Term Care of Ontario (Canada) health-care administrative databases. We identified all women in Ontario with a GDM diagnosis with a livebirth singleton delivery between July 1, 2007 and March 31, 2018. Women with diabetes or HF before pregnancy were excluded. GDM was defined based on laboratory test results and diagnosis coding. The primary outcome was incident HF hospitalization, over a period extending from the index pregnancy until March 31, 2019. The secondary outcome was prevalent peripartum cardiomyopathy (PPCM) at index pregnancy. Estimates of association were adjusted for relevant cardiometabolic risk factors.</p> <p><b>Results</b>: Among 906,319 eligible women (mean age: 30 years [SD: 5.6], 50,193 with GDM [5.5%]), there were 763 HF events over a median 7 years. GDM was associated with a higher risk of incident HF (adjusted hazard ratio [aHR]: 1.62, 95% CI: 1.28, 2.05), compared to no-GDM. This association remained significant after accounting for chronic kidney disease, post-partum diabetes, hypertension, and coronary artery disease (aHR: 1.39, 95% CI: 1.09, 1.79). GDM increased the odds of PPCM (adjusted odds ratio: 1.83, 95% CI: 1.45, 2.33).</p> <p><b>Conclusions</b>: In a large observational study, GDM was associated with an increased risk of HF. Consequently, diabetes screening during pregnancy is suggested to identify women at risk of HF.</p> <br> <p> </p>

scholarly journals Ghrelin in Serum and Urine of Post-Partum Women with Gestational Diabetes Mellitus

2018 ◽  
Vol 19 (10) ◽  
pp. 3001 ◽  
Author(s):  
Żaneta Kimber-Trojnar ◽  
Jolanta Patro-Małysza ◽  
Katarzyna Skórzyńska-Dziduszko ◽  
Jan Oleszczuk ◽  
Marcin Trojnar ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Body Composition ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Post Partum ◽  
Enzyme Linked Immunosorbent Assay ◽  
Hydration Status ◽  
Increased Risk ◽  
Serum Ghrelin ◽  
Serum And Urine

Women with a previous history of gestational diabetes mellitus (GDM) have a significantly increased risk of developing type 2 diabetes, obesity, and cardiovascular diseases in the future. The aim of the study was to evaluate ghrelin concentrations in serum and urine in the GDM group in the early post-partum period, with reference to laboratory results, body composition, and hydration status. The study subjects were divided into two groups, that is, 28 healthy controls and 26 patients with diagnosed GDM. The maternal body composition and hydration status were evaluated by the bioelectrical impedance analysis (BIA) method. The concentrations of ghrelin in the maternal serum and urine were determined via enzyme-linked immunosorbent assay (ELISA). The laboratory and BIA results of the mothers with GDM were different from those without GDM. Urine ghrelin positively correlated with serum ghrelin and high-density lipoprotein cholesterol (HDL) levels in healthy mothers. There were direct correlations between urine ghrelin and HDL as well as triglycerides levels in the GDM group. Neither the lean tissue index nor body cell mass index were related to the serum ghrelin concentrations in this group. Only the urine ghrelin of healthy mothers correlated with the fat tissue index. Our results draw attention to urine as an easily available and appropriable biological material for further studies.

Inflammatory bowel disease and new-onset psychiatric disorders in pregnancy and post partum: a population-based cohort study

Gut ◽  
2019 ◽  
Vol 68 (9) ◽  
pp. 1597-1605 ◽  
Author(s):  
Simone N Vigod ◽  
Paul Kurdyak ◽  
Hilary K Brown ◽  
Geoffrey C Nguyen ◽  
Laura E Targownik ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Mental Illness ◽  
Cohort Study ◽  
Bowel Disease ◽  
Post Partum ◽  
Population Based ◽  
Incidence Rates ◽  
Increased Risk ◽  
Inflammatory Bowel ◽  
New Onset

ObjectivePatients with inflammatory bowel disease (IBD) have an elevated risk of mental illness. We determined the incidence and correlates of new-onset mental illness associated with IBD during pregnancy and post partum.DesignThis cohort study using population-based health administrative data included all women with a singleton live birth in Ontario, Canada (2002–2014). The incidence of new-onset mental illness from conception to 1-year post partum was compared between 3721 women with and 798 908 without IBD, generating adjusted HRs (aHR). Logistic regression was used to identify correlates of new-onset mental illness in the IBD group.ResultsAbout 22.7% of women with IBD had new-onset mental illness versus 20.4% without, corresponding to incidence rates of 150.2 and 132.8 per 1000 patient-years (aHR 1.12, 95% CI 1.05 to 1.20), or one extra case of new-onset mental illness per 43 pregnant women with IBD. The risk was elevated in the post partum (aHR 1.20, 95% CI 1.09 to 1.31), but not during pregnancy, and for Crohn’s disease (aHR 1.12, 95% CI 1.02 to 1.23), but not ulcerative colitis. The risk was specifically elevated for a new-onset mood or anxiety disorder (aHR 1.14, 95% CI 1.04 to 1.26) and alcohol or substance use disorders (aHR 2.73, 95% CI 1.42 to 5.26). Predictors of a mental illness diagnosis were maternal age, delivery year, medical comorbidity, number of prenatal visits, family physician obstetrical care and infant mortality.ConclusionWomen with IBD were at an increased risk of new-onset psychiatric diagnosis in the postpartum period, but not during pregnancy. Providers should look to increase opportunities for prevention, early identification and treatment accordingly.

scholarly journals Risk of aortic dissection, congestive heart failure, pneumonia and acute respiratory distress syndrome in patients with clinical vertebral fracture: a nationwide population-based cohort study in Taiwan

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e030939
Author(s):  
Feng-You Lee ◽  
Wei-Kung Chen ◽  
Cheng-Li Lin ◽  
Chia-Hung Kao ◽  
Tse-Yen Yang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Acute Respiratory Distress Syndrome ◽  
Cohort Study ◽  
Health Insurance ◽  
Aortic Dissection ◽  
Respiratory Distress Syndrome ◽  
Distress Syndrome ◽  
Research Database ◽  
Increased Risk

ObjectiveStudies on the association between clinical vertebral fractures (CVFs) and the subsequent risk of cardiopulmonary diseases, including aortic dissection (AD), congestive heart failure (CHF), pneumonia and acute respiratory distress syndrome (ARDS) are scarce. Therefore, we used the National Health Insurance Research Database to investigate whether patients with CVF have a heightened risk of subsequent AD, CHF, pneumonia and ARDS.DesignThe National Health Insurance Research Database was used to investigate whether patients with CVFs have an increased risk of subsequent AD, CHF, pneumonia and ARDS.ParticipantsThis cohort study comprised patients aged ≥18 years with a diagnosis of CVF and were hospitalised at any point during 2000–2010 (n=1 08 935). Each CVF patient was frequency-matched to a no-CVF hospitalised patients based on age, sex, index year and comorbidities (n=1 08 935). The Cox proportional hazard regressions model was used to estimate the adjusted effect of CVF on AD, CHF, pneumonia and ARDS risk.ResultsThe overall incidence of AD, CHF, pneumonia and ARDS was higher in the CVF group than in the no-CVF group (4.85 vs 3.99, 119.1 vs 89.6, 283.3 vs 183.5 and 9.18 vs 4.18/10 000 person-years, respectively). After adjustment for age, sex, comorbidities and Charlson comorbidity index score, patients with CVF had a 1.23-fold higher risk of AD (95% CI=1.03–1.45), 1.35-fold higher risk of CHF (95% CI=1.30–1.40), 1.57-fold higher risk of pneumonia (95% CI=1.54–1.61) and 2.21-fold higher risk of ARDS (95% CI=1.91–2.57) than did those without CVF. Patients with cervical CVF and SCI were more likely to develop pneumonia and ARDS.ConclusionsOur study demonstrates that CVFs are associated with an increased risk of subsequent cardiopulmonary diseases. Future investigations are encouraged to delineate the mechanisms underlying this association.

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