Transgenerational effects of maternal obesity and gestational diabetes on offspring body composition and left ventricle mass: the Finnish Gestational Diabetes Prevention Study (RADIEL) 6‐year follow‐up
Abstract:Aim
To investigate the influence of maternal adiposity and gestational diabetes on offspring body composition and left ventricle mass in early childhood.
Methods
The observational follow‐up study included 201 mother‐child pairs, a sub‐cohort from the Finnish Gestational Diabetes Prevention Study, who were recruited 6.1 ± 0.5 (mean ± SD) years postpartum, aiming for an equal number of mothers with and without gestational diabetes.
Results
Maternal pre‐pregnancy BMI (mean ± SD; 30.5 ± 5.6 kg/m2) was associated w… Show more
“…Offspring anthropometrics, body composition, BP, and LV mass were not related to GDM exposure, but children following GDM pregnancies had lower resting HR (Table 2 ). Detailed child and maternal background associations have been presented in our previous work [ 9 , 10 ].…”
Section: Resultsmentioning
confidence: 99%
“…LV mass was calculated with the Devereux formula [ 21 ] and converted to Z -score [ 22 ]. We have previously published on associations between GDM and maternal/child adiposity and child LV mass [ 10 ], and in this manuscript, we focused on LV mass relations with LV diastolic function. Fig.…”
Section: Methodsmentioning
confidence: 99%
“…In our previous work, we have found that maternal pregravida obesity, but not GDM was associated with offspring early vascular structure changes, but neither had the effect on child LV mass in early childhood [ 9 , 10 ]. In this study, we aim to investigate associations between maternal pre-pregnancy obesity, GDM, offspring body composition, and LV diastolic and systolic function.…”
Aims
We aimed to investigate associations between pre-pregnancy obesity, gestational diabetes (GDM), offspring body composition, and left ventricular diastolic and systolic function in early childhood.
Methods
This is an observational study, including 201 mother–child pairs originating from the Finnish Gestational Diabetes Prevention Study (RADIEL; 96 with GDM, 128 with pre-pregnancy obesity) with follow-up from gestation to 6-year postpartum. Follow-up included dyads anthropometrics, body composition, blood pressure, and child left ventricular function with comprehensive echocardiography (conventional and strain imaging).
Results
Offspring left ventricular diastolic and systolic function was not associated with gestational glucose concentrations, GDM, or pregravida obesity. Child body fat percentage correlated with maternal pre-pregnancy BMI in the setting of maternal obesity (r = 0.23, P = 0.009). After adjusting for child lean body mass, age, sex, systolic BP, resting HR, maternal lean body mass, pre-gestational BMI, and GDM status, child left atrial volume increased by 0.3 ml (95% CI 0.1, 0.5) for each 1% increase in child body fat percentage.
Conclusions
No evidence of foetal cardiac programming related to GDM or maternal pre-pregnancy obesity was observed in early childhood. Maternal pre-pregnancy obesity is associated with early weight gain. Child adiposity in early childhood is independently associated with increased left atrial volume, but its implications for long-term left ventricle diastolic function and cardiovascular health remain unknown.
“…Offspring anthropometrics, body composition, BP, and LV mass were not related to GDM exposure, but children following GDM pregnancies had lower resting HR (Table 2 ). Detailed child and maternal background associations have been presented in our previous work [ 9 , 10 ].…”
Section: Resultsmentioning
confidence: 99%
“…LV mass was calculated with the Devereux formula [ 21 ] and converted to Z -score [ 22 ]. We have previously published on associations between GDM and maternal/child adiposity and child LV mass [ 10 ], and in this manuscript, we focused on LV mass relations with LV diastolic function. Fig.…”
Section: Methodsmentioning
confidence: 99%
“…In our previous work, we have found that maternal pregravida obesity, but not GDM was associated with offspring early vascular structure changes, but neither had the effect on child LV mass in early childhood [ 9 , 10 ]. In this study, we aim to investigate associations between maternal pre-pregnancy obesity, GDM, offspring body composition, and LV diastolic and systolic function.…”
Aims
We aimed to investigate associations between pre-pregnancy obesity, gestational diabetes (GDM), offspring body composition, and left ventricular diastolic and systolic function in early childhood.
Methods
This is an observational study, including 201 mother–child pairs originating from the Finnish Gestational Diabetes Prevention Study (RADIEL; 96 with GDM, 128 with pre-pregnancy obesity) with follow-up from gestation to 6-year postpartum. Follow-up included dyads anthropometrics, body composition, blood pressure, and child left ventricular function with comprehensive echocardiography (conventional and strain imaging).
Results
Offspring left ventricular diastolic and systolic function was not associated with gestational glucose concentrations, GDM, or pregravida obesity. Child body fat percentage correlated with maternal pre-pregnancy BMI in the setting of maternal obesity (r = 0.23, P = 0.009). After adjusting for child lean body mass, age, sex, systolic BP, resting HR, maternal lean body mass, pre-gestational BMI, and GDM status, child left atrial volume increased by 0.3 ml (95% CI 0.1, 0.5) for each 1% increase in child body fat percentage.
Conclusions
No evidence of foetal cardiac programming related to GDM or maternal pre-pregnancy obesity was observed in early childhood. Maternal pre-pregnancy obesity is associated with early weight gain. Child adiposity in early childhood is independently associated with increased left atrial volume, but its implications for long-term left ventricle diastolic function and cardiovascular health remain unknown.
“…The most recent and comprehensive searches in the genetic and epigenetic etiology of GDM have been reviewed elsewhere [ 90 , 91 ]. These epigenetic modifications may result in maternal and paternal transgenerational inheritance of obesity and glucose intolerance in the offspring [ 92 , 93 , 94 ]. Moreover, the types of genetic variation and the mechanisms of epigenetics may contribute to genotypic and phenotypic characteristics in different ethnicities [ 95 , 96 ].…”
Gestational diabetes mellitus (GDM), characterized by a transitory form of diabetes induced by insulin resistance and pancreatic β-cell dysfunction during pregnancy, has been identified as one of the major obstacles in achieving improved maternal and child health. Approximately 9–25% of pregnancies worldwide are impacted by the acute, long-term, and transgenerational health complications of this disease. Here, we discuss how GDM affects longstanding maternal and neonatal outcomes, as well as health risks that likely persist into future generations. In addition to the current challenges in the management and diagnosis of and the complications associated with GDM, we discuss current preclinical models of GDM to better understand the underlying pathophysiology of the disease and the timely need to increase our scientific toolbox to identify strategies to prevent and treat GDM, thereby advancing clinical care.
“…Given the relationship between Baby New Year and Father Time, it is perhaps fitting that we consider the transgenerational effects of gestational diabetes. Gestational diabetes is known to trigger left ventricle hypertrophy and this was investigated in a study of 201 mother–child pairs . It is reassuring that, although adiposity in early childhood was associated with maternal pre‐pregnancy obesity, no direct influence on the child's left ventricular mass was found.…”
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