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The Risk of Hypertension and Diabetes Mellitus According to Offspring's Birthweight in Women With Normal Body Mass Index: A Nationwide Population-Based Studyopen access

Authors
Jung, Young MiWi, WonyoungCho, Kyu-DongHong, Su JungKim, Ho YeonAhn, Ki HoonHong, Soon-CheolKim, Hai-JoongOh, Min-JeongCho, Geum Joon
Issue Date
Feb-2024
Publisher
대한의학회
Keywords
Offspring's Birthweight; Diabetes; Hypertension; Adverse Pregnancy Outcome
Citation
Journal of Korean Medical Science, v.39, no.5
Indexed
SCIE
SCOPUS
KCI
Journal Title
Journal of Korean Medical Science
Volume
39
Number
5
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/65861
DOI
10.3346/jkms.2024.39.e50
ISSN
1011-8934
1598-6357
Abstract
Background: Maladaptation to vascular, metabolic, and physiological changes during pregnancy can lead to fetal growth disorders. Moreover, adverse outcomes during pregnancy can further increase the risk of cardiovascular and metabolic diseases in mothers. Delivering a large-for-gestational-age (LGA) baby may indicate a pre-existing metabolic dysfunction, whereas delivering a small-for-gestational-age (SGA) baby may indicate a pre-existing vascular dysfunction. This study aims to assess the risk of hypertension (HTN) and diabetes mellitus (DM) in women with normal body mass index (BMI) scores who did not experience gestational DM or hypertensive disorders during pregnancy based on the offspring's birthweight. Methods: This retrospective nationwide study included women with normal BMI scores who delivered a singleton baby after 37 weeks. Women with a history of DM or HTN before pregnancy and those with gestational DM or hypertensive disorders, were excluded from the study. We compared the risk of future maternal outcomes (HTN and DM) according to the offspring's birthweight. Multivariate analyses were performed to estimate the hazard ratio (HR) for the future risk of HTN or DM. Results: A total of 64,037 women were included in the analysis. Of these, women who delivered very LGA babies (birthweight > 97th percentile) were at a higher risk of developing DM than those who delivered appropriate-for-gestational-age (AGA) babies (adjusted HR = 1.358 [1.068-1.727]), and women who delivered very SGA babies (birthweight < 3rd percentile) were at a higher risk of developing HTN than those who delivered AGA babies (adjusted HR = 1.431 [1.181-1.734]), even after adjusting for age, parity, gestational age at delivery, fetal sex, maternal BMI score, and a history of smoking. Conclusion: These findings provide a novel support for the use of the offspring's birthweight as a predictor of future maternal diseases such as HTN and DM.
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Young, Mi Jung
Guro Hospital (Department of Obstetrics and Gynecology, Guro Hospital)
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