“Maternal diabetes mellitus and its impact on the risk of delivering a child with congenital heart disease: a systematic review and meta-analysis”

Papazoglou, Αndreas S.; Moysidis, Dimitrios V.; Panagopoulos, Periklis; Kaklamanos, Eleftherios G.; Tsagkaris, Christos; Vouloagkas, Ioannis; Karagiannidis, Efstratios; Tagarakis, Georgios I; Papamitsou, Theodora; Papanikolaou, Ioannis G; Christodoulaki, Chrysi; Vrachnis, Nikolaos

doi:10.1080/14767058.2021.1960968

Cited by 16 publications

(12 citation statements)

References 42 publications

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“…Diabetes mellitus is considered to be one of the most important independent risk factors for most adverse perinatal outcomes, including major foetal malformations and stillbirth [ 7 , 8 , 13 ]. Obese women are more insulin resistant than normal weight women.…”

Section: Discussionmentioning

confidence: 99%

“…The teratogenic effects of hyperglycaemia may be aggravated by obesity, improper nutrition, smoking, and alcohol use. Foetal complications include major congenital malformations, most commonly related to the cardiovascular system [ 8 ]. Adverse pregnancy outcomes also comprise macrosomia and shoulder dystocia with vaginal delivery, neonatal hypoxic-ischaemic encephalopathy, and even neonatal mortality.…”

Section: Introductionmentioning

confidence: 99%

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The influence of advanced age and obesity on pregnancy course and outcome in patients with diabetes mellitus

Bapayeva¹,

Terzić²,

Dotlić³

et al. 2022

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Introduction Older women are at greater risk of suffering from a series of comorbidities such as obesity, diabetes, and hypertension that could negatively affect pregnancy course and outcomes. This study aims to investigate the impact of maternal age and pre-pregnancy body mass index (BMI) on pregnancy outcomes of women with diabetes mellitus (DM). Material and methods The study included 323 diabetic pregnant women. All complications throughout pregnancy and the early neonatal period were noted. The women were divided into groups according to age decade and BMI. Results 84.8% of women reported pregnancy complications, with a higher prevalence in obese women ( p = 0.003). However, most children had a good outcome with few early neonatal complications (36.85%). Old and obese women with DM often showed complications, and their newborns had higher birth weight ( p = 0.003) and more neonatal complications ( p = 0.041). Maternal BMI ( p = 0.016; OR = 1.064), but not age ( p = 0.801), was found to be a significant predictor of pregnancy complications. Conclusions Pregnant women with DM should be considered as high-risk patients. Advanced age and increased BMI prior to pregnancy are risk factors for pregnancy complications. Maternal obesity is the most important predictor of pregnancy complications in women with DM. Pregnancy outcome can be good for both mothers and children with a timely and adequate approach.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The influence of advanced age and obesity on pregnancy course and outcome in patients with diabetes mellitus

Bapayeva¹,

Terzić²,

Dotlić³

et al. 2022

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“…Maternal diabetes-induced congenital malformations can affect any developing organ or system. Congenital heart disease (CHD) is one of the most common congenital diseases, affecting the health of millions of newborns annually [ 9 ]. The pathogenesis of CHD is complex, and its exact etiology is largely unknown.…”

Section: Introductionmentioning

confidence: 99%

Associations of elevated glucose levels at each time point during OGTT with fetal congenital heart diseases: a cohort study of 72,236 births

Zhang,

Lai,

Zhang

et al. 2023

BMC Pregnancy Childbirth

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Background It remains unclear how the condition of glucose metabolism during pregnancy affects fetal outcomes. This study aimed to investigate the associations of gestational diabetes mellitus (GDM) and elevated glucose levels at each time point during oral glucose tolerance test (OGTT) with congenital heart disease (CHD) risk in offspring. Methods We conducted a retrospective cohort study of mothers with singleton pregnancies of 20 weeks or more registered at Maternal and Child Health Centers in Fujian Province, China. The OGTT results and offspring CHD occurrence were collected. We used logistic regression to analyse the association between elevated blood glucose at each time point during OGTT and CHD. Results A total of 71,703 normal and 533 CHD fetuses were included. Compared to the corresponding normal group, women with GDM, elevated blood glucose at different time points in OGTT (0 h ≥ 5.1 mmol/L, 1 h ≥ 10 mmol/L, and 2 h ≥ 8.5 mmol/L) showed an increased risk of CHD in offspring (adjusted OR = 1.41, 1.36, 1.37, and 1.41, all P < 0.05, respectively). Compared to group 1 (normal OGTT 0 h, 1 h and 2 h), the risk of CHD was higher in group 3 (normal OGTT 0 h and abnormal OGTT 1 h or 2 h) and group 4 (abnormal OGTT 0 h, 1 h and 2 h), OR = 1.53 and 2.21, all P < 0.05, respectively. Moreover, we divided participants by advanced maternal age, multipara, assisted reproduction, fetal sex, and others, similar associations were observed in the subgroup analyses. Conclusion Elevated blood glucose at different time points during OGTT was associated with CHD in offspring. Fetuses of pregnant women with GDM should be screened for a high risk of CHD.

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“…Wu Y [8] also found that pre-pregnancy GDM and GDM were risk factors for neonatal congenital heart disease through the study of 29211974 pregnant women. A metaanalysis of the literature found that the risk of congenital heart disease in the offspring of GDM pregnant women was signi cantly lower than that of pregestational diabetes mellitus pregnant women, and diabetes-induced malformations occurred in the very early stage of cardiac development [9] .…”

Section: Introductionmentioning

confidence: 99%

Analysis of maternal factors affecting the occurrence of congenital heart disease in newborns in Lanzhou area and potency of a nomogram prediction model

Jiao,

Sun,

Jing

et al. 2023

Preprint

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Objective To analyze the maternal influencing factors of neonatal congenital heart defects (CHDs), to achieve the effect of prevention of neonatal CHDs. Methods A questionnaire survey was conducted on 134 newborns with CHDs from March 2022 to January 2023 as the case group, and 268 pregnant women were included in the control group according to the 1: 2 matching principle with age as the matching condition. Baseline data, pregnancy complications, and other clinical data of all subjects were collected. Logistic regression analysis was used to screen the risk factors affecting neonatal congenital heart disease. R software was used to construct a nomogram model for predicting the incidence of congenital heart disease. Results Logistic regression analysis showed that hypertensive disorder complicating pregnancy ( HDCP ) was a risk factor for CHDs ( OR = 3.77,95% CI : 2.18–6.53 ), gestational diabetes mellitus ( GDM ) was a risk factor for CHDs ( OR = 3.69,95% CI : 2.11–6.46 ), and keeping cats during pregnancy was a risk factor for CHDs ( OR = 2.73,95% CI : 1.02–7.34 ). The probability of GDM leading to congenital heart disease in offspring was 49.70%, the probability of HDCP leading to congenital heart disease in offspring was 48.60%, and the probability of raising cats during pregnancy leading to congenital heart disease in offspring was 38.00%.he probability of CHDs in offspring induced by HDCP and GDM was 78.70%, the probability of CHDs in offspring induced by HDCP and cats was 70.90%, the probability of CHDs in offspring induced by GDM and cats was 70.30%, and the probability of CHDs in offspring induced by HDCP, GDM, and cats was 90.50%. The nomogram predicts that the correction curve of the offspring CHDs model approaches the ideal curve. Conclusion We established a nomogram model of maternal influencing factors to predict the risk of congenital heart disease in neonates with good differentiation and consistency. This novel predictive model will help clinicians prevent congenital heart disease in offspring by improving maternal influencing factors.

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“Maternal diabetes mellitus and its impact on the risk of delivering a child with congenital heart disease: a systematic review and meta-analysis”

Cited by 16 publications

References 42 publications

The influence of advanced age and obesity on pregnancy course and outcome in patients with diabetes mellitus

The influence of advanced age and obesity on pregnancy course and outcome in patients with diabetes mellitus

Associations of elevated glucose levels at each time point during OGTT with fetal congenital heart diseases: a cohort study of 72,236 births

Analysis of maternal factors affecting the occurrence of congenital heart disease in newborns in Lanzhou area and potency of a nomogram prediction model

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