title: The Association of Family History of Premature Cardiovascular Disease or Diabetes Mellitus on the Occurrence of Gestational Hypertensive Disease and Diabetes.
abstract: BACKGROUND
  Gestational hypertensive diseases (GHD) and gestational diabetes mellitus (GDM) increase the risk of cardiovascular disease (CVD) later in life. However, the association between gestational medical diseases and familial history of CVD has not been investigated to date. In the present study, we examined the association between familial history of CVD and GHD or GDM via reliable questionnaires in a large cohort of registered nurses.
  
  
  METHODS
  The Korean Nurses' Survey was conducted through a web-based computer-assisted self-interview, which was developed through consultation with cardiologists, gynecologists, and statisticians. We enrolled a total of 9,989 female registered nurses who reliably answered the questionnaires including family history of premature CVD (FHpCVD), hypertension (FHH), and diabetes mellitus (FHDM) based on their medical knowledge. Either multivariable logistic regression analysis or generalized estimation equation was used to clarify the effect of positive family histories on GHD and GDM in subjects or at each repeated pregnancy in an individual.
  
  
  RESULTS
  In this survey, 3,695 subjects had at least 1 pregnancy and 8,783 cumulative pregnancies. Among them, 247 interviewees (6.3%) experienced GHD and 120 (3.1%) experienced GDM. In a multivariable analysis adjusted for age, obstetric, and gynecologic variables, age at the first pregnancy over 35 years (adjusted OR 1.61, 95% CI 1.02-2.43) and FHpCVD (adjusted OR 1.60, 95% CI 1.16-2.22) were risk factors for GHD in individuals, whereas FHH was not. FHDM and history of infertility therapy were risk factors for GDM in individuals (adjusted OR 2.68, 95% CI 1.86-3.86; 1.84, 95% CI 1.05-3.23, respectively). In any repeated pregnancies in an individual, age at the current pregnancy and at the first pregnancy, and FHpCVD were risk factors for GHD, while age at the current pregnancy, history of infertility therapy, and FHDM were risk factors for GDM.
  
  
  CONCLUSIONS
  The FHpCVD and FHDM are significantly associated with GHD and GDM, respectively. Meticulous family histories should be obtained, and women with family histories of these conditions should be carefully monitored during pregnancy.
authors.affiliation: Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Dong-Ju
authors.initials: DJ
authors.lastname: Choi
authors.affiliation: Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Chang-Hwan
authors.initials: CH
authors.lastname: Yoon
authors.affiliation: Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Heesun
authors.initials: H
authors.lastname: Lee
authors.affiliation: MRCC, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: So-Yeon
authors.initials: SY
authors.lastname: Ahn
authors.affiliation: Department of Obstetrics & Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Kyung Joon
authors.initials: KJ
authors.lastname: Oh
authors.affiliation: Division of Cardiovascular and Rare Diseases, Center for Biomedical Science, National Institute of Health, Chungbuk, Korea.
authors.forename: Hyun-Young
authors.initials: HY
authors.lastname: Park
authors.affiliation: Korean Nurses Association, Seoul, Korea.
authors.forename: Hea Young
authors.initials: HY
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Chungbuk National University, Chungbuk, Korea.
authors.forename: Myeong Chan
authors.initials: MC
authors.lastname: Cho
authors.affiliation: Cardiology Division, School of Medicine, Ewha Womans University, Seoul, Korea.
authors.forename: Ick-Mo
authors.initials: IM
authors.lastname: Chung
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Mi-Seung
authors.initials: MS
authors.lastname: Shin
authors.affiliation: Division of Cardiology, Cardiovascular Imaging Center, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Sung-Ji
authors.initials: SJ
authors.lastname: Park
authors.affiliation: Cardiology Division, Severance Cardiovascular Hospital, Yonsei University, Seoul, Korea.
authors.forename: Chi Young
authors.initials: CY
authors.lastname: Shim
authors.affiliation: Department of Cardiovascular Medicine, Dongtan Sacred Heart Hospital, Hwaseong, Korea.
authors.forename: Seong Woo
authors.initials: SW
authors.lastname: Han
authors.affiliation: Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: In-Ho
authors.initials: IH
authors.lastname: Chae
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000150:complications*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D016640:Diabetes, Gestational / Q000209:etiology*; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000209:etiology*; D008487:Medical History Taking / Q000706:statistics & numerical data*; D009726:Nurses / Q000706:statistics & numerical data; D011247:Pregnancy; D018570:Risk Assessment; D012307:Risk Factors