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Maternal Diabetes and Cardiovascular Health in the Offspring

Riasoya Jodah1, Alisa Arunamata2, Alaina K Kipps2

  • 1Stanford University School of Medicine, Palo Alto, CA, USA.

Pediatric Cardiology
|November 6, 2023
PubMed

Insights

Maternal diabetes, particularly pregestational diabetes mellitus (PGDM), is linked to increased arterial stiffness in newborns. These infants later show higher weight and blood pressure, indicating potential long-term cardiovascular risks.

Area of Science:

  • Cardiovascular Health
  • Neonatal Health
  • Maternal-Fetal Medicine

Background:

  • Pulse wave velocity (PWV) is a marker for cardiovascular health in adults, but its role in neonates is less understood.
  • Maternal diabetes during pregnancy can impact fetal development and long-term health outcomes.
  • Investigating neonatal arterial stiffness may reveal early indicators of cardiovascular risk associated with maternal diabetes.

Purpose of the Study:

  • To evaluate the association between neonatal arterial stiffness and maternal diabetes (pregestational and gestational).
  • To assess the relationship between neonatal arterial stiffness and subsequent childhood health outcomes, including weight and blood pressure.
  • To explore the impact of maternal glycemic control on neonatal arterial stiffness and childhood health.

Main Methods:

  • Neonatal brachial-femoral pulse wave velocity (bfPWV) was measured in infants born to mothers with pregestational diabetes mellitus (PGDM), gestational diabetes mellitus (GDM), and controls.
  • Infants were followed for a median of 5.2 years, with data collected on weight, height, and blood pressure.
  • Maternal glycemic control (HbA1c) and neonatal characteristics were recorded.

Main Results:

  • Neonates of mothers with PGDM exhibited higher bfPWV compared to controls (3.4 ± 0.5 vs. 2.6 ± 0.8 m/s, p=0.04).
  • Children born to mothers with diabetes showed increased weight percentile (78.5 ± 27.9 vs. 49.5 ± 34.6%, p=0.02) and diastolic blood pressure (68 ± 13.6 vs. 57.3 ± 4.3 mmHg, p=0.01) at follow-up.
  • No significant correlation was found between neonatal PWV and childhood BMI or maternal HbA1c.

Conclusions:

  • Maternal diabetes adversely affects neonatal arterial stiffness and is associated with elevated blood pressure and weight in childhood.
  • The precise mechanisms linking maternal diabetes to neonatal arterial stiffness and subsequent childhood health require further investigation.
  • Early detection of arterial stiffness in neonates exposed to maternal diabetes may offer insights into long-term cardiovascular risk stratification.

Keywords:
Arterial stiffnessDiabetes mellitusOffspringPulse wave velocity

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