Associations of maternal gestational diabetes mellitus with alterations in cardiovascular system in early childhood

Li, Zhuoyan; Wu, Yujian; Du, Baigang; Yu, Xiaodan; Hualing, Wang; Niu, Yiwei; Wang, Jian; Sun, Chen; Kim, Sun

doi:10.1002/dmrr.3551

Cited by 6 publications

(6 citation statements)

References 63 publications

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“…ADA diabetes classification criteria were used in six studies for PDM and GDM ( 5 , 28 , 35 , 37 , 38 , 43 ), NICE criteria were used in one study for GDM ( 25 ), and WHO criteria were used in three studies for GDM ( 2 , 23 , 42 ). Four studies used local diagnostic criteria for PDM and GDM ( 3 , 32 , 34 , 40 ), and 17 studies did not address criteria for diabetes diagnosis at all.…”

Section: Resultsmentioning

confidence: 99%

“…Eighteen studies reported maternal HbA1c and/or diabetes therapy. Analysis of echocardiography was blinded in 12 studies ( 1 , 4 , 6 , 7 , 25 , 28 , 31 , 37 , 38 , 41 , 43 , 44 ). Five studies adjusted for potential confounders such as race, birth weight, maternal age and time elapsed from delivery to postnatal outcome acquisition ( 3 , 25 , 41 , 43 , 44 ).…”

Section: Resultsmentioning

confidence: 99%

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Diabetes in pregnancy and offspring cardiac function: a systematic review and meta-analysis

Skovsgaard,

Møller,

Bjerre

et al. 2024

Front. Pediatr.

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IntroductionDiabetes in pregnancy is associated with impaired offspring cardiac function. The objective of this systematic review was to determine the effect of diabetes in pregnancy on cardiac function in the offspring measured by echocardiography.MethodsPubMed, Embase, Cochrane CENTRAL and Web of Science databases were searched from 1992 to June 27, 2023. Studies reporting offspring (age < 18 years) cardiac function by echocardiography compared between any type of diabetes in pregnancy and healthy control pregnancies were included. Study selection, quality assessment and risk of bias was independently performed by two reviewers. Meta-analyses was performed where possible.ResultsThirty-one observational studies were included 1,679 cases and 2,694 controls. In the first week of life (23 studies, n = 2,663), intraventricular septum diastolic diameter (hypertrophy) was increased, while myocardial performance index (global function) and LV E/A-ratio (diastolic function) were decreased. No difference was found for left ventricular ejection fraction (systolic function). At 1–6 months (4 studies, n = 454) studies found hypertrophy, and decreased global function, but no difference in systolic or diastolic function. At 1–8 years (7 studies, n = 1,609) no difference was found. The available data did not allow for sub-analysis based on the type of diabetes, treatment, or glycemic control.ConclusionsDiabetes in pregnancy is associated with cardiac hypertrophy and impaired global cardiac function in infants up to six months old. The few studies reporting on older children found no difference in the parameters investigated. Longitudinal studies employing more advanced echocardiographic measures or MRI are needed to evaluate consequences for long-term cardiac health.Systematic Review Registrationhttps://www.crd.york.ac.uk/, identifier (CRD42022312471).

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Diabetes in pregnancy and offspring cardiac function: a systematic review and meta-analysis

Skovsgaard,

Møller,

Bjerre

et al. 2024

Front. Pediatr.

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“…A study reported that maternal hyperglycemia during the first half of pregnancy was associated with lower childhood left ventricular mass and left ventricular end-diastolic volume [5]. Offspring of mothers with gestational diabetes mellitus (GDM) exhibited higher blood pressure and cardiac structural changes during early childhood [19,20]. Kaseva et al assessed cardiometabolic biomarkers and blood pressure in adult offspring of mothers with GDM and found increased markers of insulin resistance and a more atherogenic lipid profile [21].…”

Section: Maternal Diabetesmentioning

confidence: 99%

Research Progress of Maternal Metabolism on Cardiac Development and Function in Offspring

et al. 2023

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The developmental origin of health and disease (DOHaD) hypothesis refers to the adverse effects of suboptimal developmental environments during embryonic and early fetal stages on the long-term health of offspring. Intrauterine metabolic perturbations can profoundly impact organogenesis in offspring, particularly affecting cardiac development and giving rise to potential structural and functional abnormalities. In this discussion, we contemplate the existing understanding regarding the impact of maternal metabolic disorders, such as obesity, diabetes, or undernutrition, on the developmental and functional aspects of the offspring’s heart. This influence has the potential to contribute to the susceptibility of offspring to cardiovascular health issues. Alteration in the nutritional milieu can influence mitochondrial function in the developing hearts of offspring, while also serving as signaling molecules that directly modulate gene expression. Moreover, metabolic disorders can exert influence on cardiac development-related genes epigenetically through DNA methylation, levels of histone modifications, microRNA expression, and other factors. However, the comprehensive understanding of the mechanistic underpinnings of these phenomena remains incomplete. Further investigations in this domain hold profound clinical significance, as they can contribute to the enhancement of public health and the prevention of cardiovascular diseases.

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“…Regardless of GDM diagnosis, maternal hyperglycemia along the whole spectrum has been linearly associated with adverse perinatal outcomes in both mother and offspring [ 5 ]. Exposure to maternal hyperglycemia in utero is also associated with an increased risk for the development of chronic diseases later in childhood, including obesity [ 6 ], metabolic [ 7 ] and cardiovascular diseases [ 8 ], asthma [ 9 ], autism [ 10 ], as well as other adverse neurodevelopmental outcomes [ 11 ]. The Developmental Origin of Health and Disease (DOHaD) hypothesis is central to the concept of fetal programming and based on lasting fetal metabolic adaptions to environmental/maternal stressors during the critical developmental period [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Maternal glycemia in pregnancy is longitudinally associated with blood DNAm variation at the FSD1L gene from birth to 5 years of age

et al. 2023

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Background In utero exposure to maternal hyperglycemia has been associated with an increased risk for the development of chronic diseases in later life. These predispositions may be programmed by fetal DNA methylation (DNAm) changes that persist postnatally. However, although some studies have associated fetal exposure to gestational hyperglycemia with DNAm variations at birth, and metabolic phenotypes in childhood, no study has yet examined how maternal hyperglycemia during pregnancy may be associated with offspring DNAm from birth to five years of age. Hypothesis Maternal hyperglycemia is associated with variation in offspring DNAm from birth to 5 years of age. Methods We estimated maternal hyperglycemia using the area under the curve for glucose (AUCglu) following an oral glucose tolerance test conducted at 24–30 weeks of pregnancy. We quantified DNAm levels in cord blood (n = 440) and peripheral blood at five years of age (n = 293) using the Infinium MethylationEPIC BeadChip (Illumina). Our total sample included 539 unique dyads (mother–child) with 194 dyads having DNAm at both time-points. We first regressed DNAm M-values against the cell types and child age for each time-point separately to account for the difference by time of measurement for these variables. We then used a random intercept model from the linear mixed model (LMM) framework to assess the longitudinal association between maternal AUCglu and the repeated measures of residuals of DNAm. We adjusted for the following covariates as fixed effects in the random intercept model: maternal age, gravidity, smoking status, child sex, maternal body mass index (BMI) (measured at first trimester of pregnancy), and a binary variable for time-point. Results In utero exposure to higher maternal AUCglu was associated with lower offspring blood DNAm levels at cg00967989 located in FSD1L gene (β = − 0.0267, P = 2.13 × 10–8) in adjusted linear regression mixed models. Our study also reports other CpG sites for which DNAm levels were suggestively associated (P < 1.0 × 10–5) with in utero exposure to gestational hyperglycemia. Two of these (cg12140144 and cg07946633) were found in the promotor region of PRDM16 gene (β: − 0.0251, P = 4.37 × 10–07 and β: − 0.0206, P = 2.24 × 10–06, respectively). Conclusion Maternal hyperglycemia is associated with offspring DNAm longitudinally assessed from birth to 5 years of age.

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Associations of maternal gestational diabetes mellitus with alterations in cardiovascular system in early childhood

Cited by 6 publications

References 63 publications

Diabetes in pregnancy and offspring cardiac function: a systematic review and meta-analysis

Diabetes in pregnancy and offspring cardiac function: a systematic review and meta-analysis

Research Progress of Maternal Metabolism on Cardiac Development and Function in Offspring

Maternal glycemia in pregnancy is longitudinally associated with blood DNAm variation at the FSD1L gene from birth to 5 years of age

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