Mothers With Diabetes, Kids With Heart Disease

Intrauterine environment may have a 'programming effect' on fetal heart

Maternal diabetes before or during pregnancy is associated with increased risks of metabolic syndrome and congenital heart disease in offspring. Research has shown that the children of mothers with elevated blood sugar that is shy of level that would categorize them as having of gestational diabetes are, nonetheless, more likely to be obese. But less is known about the associations between prenatal exposure to maternal diabetes  and early-onset CVD in infants. So researchers from Aarhus University Hospital, Denmark, and University of California, Los Angeles, looked at data from nearly 2.5 million births to find out more. They reported their results on Dec. 4, 2019, on the BMJ website, 

During up to 40 years of follow-up, 1,153 offspring of mothers with diabetes were diagnosed with CVD, as were 91,311 children of mothers without diabetes. The offspring of mothers with diabetes had a 29% increased overall rate of early-onset CVD.

Children of mothers with diabetes were also more likely to have diabetes, hypertension, hypercholesterolemia, and chronic kidney diseases, and to be obese. The rates of specific types of CVD were increased for heart failure, and close to doubled for hypertensive disease, deep vein thrombosis, and pulmonary embolism. A mother with diabetes and CVD herself also nearly doubled the offspring’s chances of early-onset CVD.

The diabetic intrauterine environment could have a “programming effect” on the development of CVD in children, the researchers say. They note that during pregnancies complicated by diabetes, large amounts of maternal glucose freely cross the placenta, which could lead to increased secretion of fetal insulin. Exposure to hyperinsulinemia and hyperglycemia could have long-lasting effects, they say, and result in changes in vascular function. Their findings underscore the importance of screening for diabetes risks, especially in pregnant women, to avoid multigenerational hits to heart health.