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Cited by 15Birth, Development, and HealthCardiovascular Function and Risk FactorsGestational Diabetes Research and Management

Persistent Aortic Stiffness and Left Ventricular Hypertrophy in Children of Diabetic Mothers

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Do, Victor, Eckersley, Luke, Lin, Lily, Davidge, Sandra T., Stickland, Michael K., Ojala, Tiina, Serrano-Lomelin, Jesus, Hornberger, Lisa K.·2021·CJC Open
DOI 10.1016/j.cjco.2020.10.020PMC PMC7985002
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Abstract

Background Fetuses of diabetic mothers develop left ventricular (LV) hypertrophy and are at increased long-term risk of cardiovascular disease. In our previous longitudinal study from midgestation to late infancy we showed persistence of LV hypertrophy and increased aortic stiffness compared with infants of healthy mothers, the latter of which correlated with third trimester maternal hemoglobin A1c. In the present study, we reexamined the same cohort in early childhood to determine if these cardiovascular abnormalities persisted. Methods Height, weight, and right arm blood pressure were recorded. A full functional and structural echocardiogram was performed with offline analysis of LV posterior wall and interventricular septal diastolic thickness (IVSd), systolic and diastolic function, and aortic pulse wave velocity. Vascular reactivity was assessed using digital thermal monitoring. Participants also completed a physical activity questionnaire. Results Twenty-five children of diabetic mothers (CDMs) and 20 children from healthy pregnancies (mean age, 5.6 ± 1.7 and 5.3 ± 1.3 years, respectively; P = not significant) were assessed. Compared with controls, IVSd z score was increased in CDMs (1.2 ± 0.6 vs 0.5 ± 0.3, respectively; P = 0.006), with one-fifth having a z score of more than +2.0. Aortic pulse wave velocity was increased in CDMs (3.2 ± 0.6 m/s vs 2.2 ± 0.4 m/s; P = 0.001), and correlated with IVSd z score ( R 2 = 0.81; P = 0.001) and third trimester maternal A1c ( R 2 = 0.65; P < 0.0001). Body surface area, height, weight, blood pressure, vascular reactivity, and physical activity scores did not differ between groups. Our longitudinal analysis showed that individuals with greater IVSd, and aortic stiffness in utero, early and late infancy also tended to have greater measures in early childhood ( P < 0.001 and P < 0.0001, respectively). Conclusions CDMs show persistently increased interventricular septal thickness and aortic stiffness in early childhood.

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  • A limited number of studies linked gestational diabetes mellitus exposure to increased cardiovascular disease risk in the offspring.

    “A limited number of studies linked GDM exposure to increased CVD risk in the offspring [73,83,84,85,86].”

    From Recent Experimental Studies of Maternal Obesity, Diabetes during Pregnancy and the Developmental Origins of Cardiovascular Disease (2022) · cites this paper as [86]

    The Conclusions (page unavailable) report increased aortic stiffness and interventricular septal thickness in children of diabetic mothers, which supports a link between maternal diabetes and offspring cardiovascular abnormalities. But the Methods (page unavailable) specify that the study recruited mothers with pregestational diabetes and excluded gestational diabetes; it also measured cardiovascular findings rather than subsequent CVD risk. It therefore does not establish the claim specifically for GDM exposure. (LLM, conf=0.88)

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  • Postnatal echocardiography at 6 weeks and 12 months of age, and subsequent follow-up at 3-8 years of age, showed that cardiac hypertrophy persisted long after the intrauterine exposure to hyperglycemia was removed.

    “Postnatal echocardiography at 6 weeks and 12 months of age, and subsequent follow-up at 3–8 years of age, showed that cardiac hypertrophy persisted long after the intrauterine exposure to hyperglycemia was removed [86,87].”

    From Recent Experimental Studies of Maternal Obesity, Diabetes during Pregnancy and the Developmental Origins of Cardiovascular Disease (2022) · cites this paper as [86]

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1 of the 48 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. [28]Lindsay R.S. Westgate J.A. Beattie J. Inverse changes in fetal insulin-like maternal diabetes Clin Endocrinol (Oxf) 66 2007 322 328 17302863

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Authors
Do, V., Eckersley, L., Lin, L., Davidge, S. T., Stickland, M. K., Ojala, T., Serrano-Lomelin, J., & Hornberger, L. K.
Affiliations
  • University of Alberta (CA)
  • University of Helsinki (FI)
Corresponding author
Hornberger, Lisa K.
ORCID
Venue
CJC Open
Publisher
Elsevier BV
Published
2021-03
Volume
3
Issue
3
Pages
345-353
ISSN
2589-790X (ISSN-L)
DOI
10.1016/j.cjco.2020.10.020
PMC
PMC7985002
OpenAlex
W3102435671
Cited by
15
References
48
Citations by year
2026: 3 · 2025: 1 · 2024: 2 · 2023: 4 · 2022: 3 · 2021: 2
FWCI
2.16
Type
journal article
Language
en
Open access
Licence
Locations
  • CJC Open (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Työväentutkimus Vuosikirja (submittedVersion)
Funders
  • Stollery Children’s Hospital Foundation
  • Women and Children's Health Research Institute
  • Royal Alexandra Hospital Foundation
  • Alberta Innovates - Health Solutions
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
Keywords
maternal diabetes, offspring of diabetic mothers, left ventricular hypertrophy, aortic stiffness, pulse wave velocity, interventricular septum thickness, cardiovascular risk, early childhood, vascular reactivity, physical activity

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