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Войти в исследования Preventive medicine · 2026
Late-pregnancy maternal serum alkaline phosphatase levels and risk of early postpartum cardiometabolic disease: A municipality-wide electronic health record-based cohort study in Tianjin, China.
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Xu Xiaojun, Fang Yiwen, Zhang Ruimin, Li Jingge, Zuo Lushu, Lv Lijuan, Yang Qing, Zhou Xin
Аннотация
OBJECTIVE: To investigate the association between gestational age-standardized maternal alkaline phosphatase (ALP) levels and early postpartum cardiometabolic disease.
METHODS: The study included 166,986 singleton pregnancies from the Tianjin Health and Medical Data Platform in Tianjin, China (2009-2023). Maternal serum ALP levels measured within two weeks before delivery were gestational age-standardized and categorized into quartiles. Primary outcomes were early postpartum cardiometabolic diseases including hypertension, diabetes mellitus, dyslipidemia, cardiovascular disease (CVD), and a composite outcome comprising these conditions. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).
RESULTS: During a median follow-up of 4.7 years, compared with the highest gestational age-standardized ALP quartile, the lowest quartile was associated with higher risks of postpartum hypertension (HR: 1.18, 95% CI: 1.09, 1.28), diabetes mellitus (HR: 1.23, 95% CI: 1.10, 1.37), CVD (HR: 1.17, 95% CI: 1.07, 1.28), and composite outcome (HR: 1.13, 95% CI: 1.08, 1.20). Exploratory analyses showed limited incremental discrimination after adding gestational age-standardized ALP to models containing adverse pregnancy outcomes.
CONCLUSIONS: Lower gestational age-standardized maternal ALP levels before delivery were associated with a higher risk of early postpartum cardiometabolic disease. Further studies across ethnically and geographically diverse populations are warranted to validate these findings.
METHODS: The study included 166,986 singleton pregnancies from the Tianjin Health and Medical Data Platform in Tianjin, China (2009-2023). Maternal serum ALP levels measured within two weeks before delivery were gestational age-standardized and categorized into quartiles. Primary outcomes were early postpartum cardiometabolic diseases including hypertension, diabetes mellitus, dyslipidemia, cardiovascular disease (CVD), and a composite outcome comprising these conditions. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).
RESULTS: During a median follow-up of 4.7 years, compared with the highest gestational age-standardized ALP quartile, the lowest quartile was associated with higher risks of postpartum hypertension (HR: 1.18, 95% CI: 1.09, 1.28), diabetes mellitus (HR: 1.23, 95% CI: 1.10, 1.37), CVD (HR: 1.17, 95% CI: 1.07, 1.28), and composite outcome (HR: 1.13, 95% CI: 1.08, 1.20). Exploratory analyses showed limited incremental discrimination after adding gestational age-standardized ALP to models containing adverse pregnancy outcomes.
CONCLUSIONS: Lower gestational age-standardized maternal ALP levels before delivery were associated with a higher risk of early postpartum cardiometabolic disease. Further studies across ethnically and geographically diverse populations are warranted to validate these findings.