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Won Young Wi 1 Article
Association between cardiac arrhythmia before pregnancy and gestational diabetes: a nationwide population-based study in Korea
You-Jung Choi, Won Young Wi, Geum Joon Cho, Jin Oh Na
Epidemiol Health. 2023;45:e2023103.   Published online December 4, 2023
DOI: https://doi.org/10.4178/epih.e2023103
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Abstract
Given the higher prevalence of cardiac arrhythmias in individuals with diabetes, we investigated the relationship between cardiac arrhythmias and the incidence of gestational diabetes (GDM). This retrospective cohort study utilized data from the Korean Health Insurance Service database, encompassing 1,113,729 women who gave birth between January 2007 and December 2015. After excluding those who did not undergo National Health Screening tests within 1 year prior to pregnancy, those with multifetal pregnancies, and those diagnosed with diabetes, we analyzed 365,880 singleton pregnancies without a history of diabetes. Of these, 3,253 (0.9%) had cardiac arrhythmias, including premature extra beats, supraventricular tachyarrhythmias, and/or atrial flutter/fibrillation. GDM occurred in 31,938 (8.7%) subjects during pregnancy, and was more prevalent in women with cardiac arrhythmia than in those without (14.9 vs. 8.7%, p<0.001). In the multivariate analysis, the association between cardiac arrhythmia and GDM remained statistically significant (adjusted odds ratio, 1.78; 95% confidence interval, 1.61 to 1.97; p<0.001). Subgroup analysis revealed that the risk of GDM was consistently statistically significant in subjects with cardiac arrhythmia, regardless of age, body mass index, and the presence or absence of chronic hypertension. Therefore, cardiac arrhythmias before and during pregnancy appear to be associated with an increased risk of developing GDM.
Summary
Korean summary
본 연구에서는 부정맥과 임신성 당뇨병의 발생과의 관계를 확인인하기 위하여 2007년부터 2015년까지 국민건강보험 공단 데이터를 이용하여 분만력을 가진 1,113,729명의 여성을 대상으로 진행되었습니다. 최종 분석은 과거 당뇨병 진단병력을 가지고 있는 환자를 제외하고 365,880건의 단태아 임산부를 포함하였고, 전체 대상자 중 31,938 (8.7%)에서 임신성 당뇨병을 확인하였습니다. 그 중 부정맥 병력이 확인되지 않은 임산부와 비교하였을 때, 부정맥 병력이 있는 경우 임신 기간 중 임신성 당뇨병 발생률이 높았으며 (8.7% vs. 14.9%, p<0.001), 다변량 분석에서도 부정맥과 임신 당뇨병 간의 연관성이 통계적으로 유의미하게 나타났습니다 (adjusted odds ratio, 1.78; 95% confidence interval, 1.61 to 1.97; p<0.001). 따라서, 본 연구는 임신 전후의 부정맥 병력은 임신성 당뇨병 발병 위험 증가와 관련 있음을 시사합니다.
Key Message
This nationwide population-based cross-sectional study using the Korean Health Insurance Service database showed that women with a history of cardiac arrhythmia had an elevated risk of incident GDM during pregnancy. The prevalence of GDM was significantly higher in women with cardiac arrhythmias (8.7% vs. 14.9%). There was a statistically significant association between cardiac arrhythmia and GDM (adjusted odds ratio: 1.78), suggesting that cardiac arrhythmias before and during pregnancy are linked to an increased risk of developing GDM, independent of age, BMI, and chronic hypertension.

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