Diabetes During Pregnancy May Up Risk of Heart Disease in Children

Pregnant mothers with diabetes often give birth to children who exhibit increased rates of early-onset cardiovascular diseases (CVD), developing any time between childhood and 40 years of age, reveals a new study from Denmark. The study, published in the British Medical Journal (BMJ), indicates that children born to mothers with a history of diabetes or CVD were more prone to develop these diseases.

The research team investigated whether there was a causal link between these two observations, in which case, effective prevention and treatment of diabetes in women of childbearing age would be highly beneficial. These health-promoting measures would not only benefit expectant mothers, but also reduce the risk of occurrence of diabetes and CVD in their children in the long run.

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Background of the Study

There has been a dramatic increase in the incidence of diabetes in pregnant women throughout the globe. Children born to these mothers are more likely to develop diabetes and CVD complications such as high blood pressure and heart problems at a much earlier age. However, it is not known whether or to what extent, in utero exposure to diabetes, increases the incidence of these health complications in newborns. The present study attempted to address these aspects.

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Key Features of the Study

The study aimed to determine the association between diabetes in women – before and during pregnancy – and early-onset of diabetes and CVD in children born to these mothers.

The main features of the study are highlighted below:

• Data was extracted from the National Registry of Denmark between 1977 and 2016
• Health data of more than 2.4 million children born without congenital heart disease were included in the study
• The children and young adults were segregated into the following groups:
• Childhood Group – Below the age of 20 years
• Early Adulthood Group – Between 20 to 40 years of age
• Diabetes in women was categorized into the following groups:
• Pregestational – Before pregnancy
• Gestational – During pregnancy
• Women with diabetic complications
• Major influential factors that were taken into account included the following:
• Mother’s age
• Mother’s level of education
• Mother’s lifestyle
• Mother’s medical history
• Duration of follow-up was from childhood up to 40 years

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Key Findings of the Study

• Children of diabetic mothers had 29 percent increased rates of early-onset CVD than those of non-diabetic mothers – Cumulative Risk: 17.8 percent vs. 13.1 percent
• Children of diabetic mothers had higher rates of the following types of CVD:
• Pulmonary embolism - 91 percent
• Deep vein thrombosis (DVT) – 82 percent
• Hypertension – 78 percent
• Heart failure – 45 percent
• Increased rates of CVD was observed in both the age groups – childhood and early adulthood
• The rates of CVD did not depend on the type of diabetes – pregestational or gestational
• The rates of CVD were similar for both Type-1 and Type-2 diabetes
• Children of mothers with concurrent diabetes and CVD had the highest rates of early-onset CVD than those of mothers with only diabetes

Strengths of the Study

The major strengths of the study include the following:

• Large sample size – 2.4 million
• Long follow-up period – 40 years
• Highly robust results – Didn’t vary even after stringent analysis

Limitations of the Study

Since the study was observational in nature, the exact cause of the increased rates of CVD could not be established, despite the adjustment of a variety of variables. Moreover, unmeasured factors could also have influenced the study results.

Future Plans

The research team plans to carry out studies that will measure the degree of glycemic (blood glucose) control in pregnant mothers and its influence on the incidence of CVD in the offspring throughout their lifetime.

Concluding Remarks

The research team concluded saying: “Our study provides evidence that children of mothers with diabetes, especially those with a history of CVD or with diabetic complications, had increased rates of early-onset CVD throughout the early decades of life.” They add: “These findings highlight the importance of effective strategies for screening and preventing diabetes in women of childbearing age.”

Funding Source

The study was funded by multiple organizations and foundations. These include the Lundbeck Foundation, the Danish Council for Independent Research, the National Natural Science Foundation of China, the NIH’s National Center for Advancing Translational Sciences, the NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development, the Nordic Cancer Union, the Karen Elise Jensens Fond, and the Novo Nordisk Foundation.

Reference:

1. Maternal Diabetes During Pregnancy and Early Onset of Cardiovascular Disease in Offspring: Population Based Cohort Study with 40 years of Follow-up - (https://doi.org/10.1136/bmj.l6398)

Source-Medindia