Children born to moms with diabetes in pregnancy may be 30-80% more likely to develop a heart condition: Study
Heart disease in teenagers and young adults may be related to exposure to diabetes in the womb, say researchers. Their analysis of young adults and teenagers, whose mothers had diabetes during their pregnancies, reveals that the child had a 50-200% higher risk of developing heart disease before they turned 35 than those who were not exposed in the womb.
The three most frequent diagnoses among the children exposed to diabetes were high blood pressure (8,713 people), type 2 diabetes (3,568 people), and ischemic heart disease (715). According to study author, Dr Jonathan McGavock, Children’s Hospital Research Institute of Manitoba, Canada, and associate professor at the University of Manitoba, they found that children born to mothers with diabetes in pregnancy were 30-80% more likely to develop a heart condition, and 2 to 3.4 times more likely to develop a heart disease risk factor (such as high blood pressure, diabetes) than children born to mothers without diabetes in pregnancy. Heart conditions and risk factors were diagnosed two years earlier in the children exposed to diabetes in the womb.
The team looked at data on 293,546 children born to 189,939 mothers in Manitoba, Canada, between 1979 and 2005. Previous studies have documented the increased risk of type 2 diabetes, but not cardiovascular disease, from in utero exposure to diabetes. The current cohort provided 3,628,576 person-years of data, and mean age at latest follow-up was 20.5 years. “It is unclear whether intrauterine exposure to maternal diabetes is associated with risk factors for cardiovascular disease and related end points in adulthood. We examined this potential association in a population-based birth cohort followed up to age 35 years,” write authors in the study published in the Canadian Medical Association Journal (CMAJ).
Of the total children, 2.8% were exposed to gestational diabetes and 1.1% to pre-existing type 2 diabetes. Exposure to both types of diabetes became more common during the study period, a trend seen elsewhere in the world. Children exposed to diabetes in utero were more likely to be born to older mothers, to be born large for gestational age, to be born preterm, and to reside in a rural area or a household with greater socioeconomic deprivation, says the report.
“In this population-based administrative birth cohort study, fetal exposure to maternal gestational diabetes or type 2 diabetes, respectively, was associated with a 1.27-fold and 1.48-fold higher risk for cardiovascular disease morbidity and a 1.85-fold and 3.38-fold higher risk for cardiovascular disease risk factors before 35 years of age, compared with not being exposed to diabetes in utero. Furthermore, the first cardiovascular disease-related outcome occurred 2 to 4 years earlier among offspring exposed to either gestational diabetes or type 2 diabetes in utero,” write authors. They add, “The higher cardiovascular disease morbidity among offspring exposed to diabetes in utero appeared to be driven by early-onset type 2 diabetes and hypertension. These observations support our hypothesis that cardiovascular disease morbidity in adolescence and early adulthood is related to exposure to maternal diabetes in utero.”
The research team suggests that these findings may be useful for preventive health practices. “Future studies should endeavor to replicate these findings in other settings and extend follow-up of similar cohorts into older age to assess whether the relative contribution of intrauterine diabetes exposure to cardiovascular disease-related morbidity remains stable over time. Screening children with in utero exposure to diabetes for cardiovascular disease risk factors might help to evaluate the future burden related to cardiovascular disease in the population,” they conclude.