Maternal diabetes and cardiac left ventricular structure and function in the infant:a Copenhagen Baby Heart Study
Objective: Prenatal exposure to maternal diabetes is associated with increased risk of offspring heart defects. We evaluated associations with subtle infant cardiac changes.
Research Design and Methods: In a cohort of 25,486 infants with transthoracic echocardiography within 60 days of birth, we investigated associations between maternal pre-existing and gestational diabetes (GDM) and infant left ventricular (LV) structural and functional parameters, using linear regression to estimate adjusted mean differences (aMD) between groups.
Results: Infants exposed to maternal pre-existing diabetes (N=198) had thicker LV posterior walls (aMD 0.19 mm, 95% confidence interval [CI] 0.11, 0.27), smaller LV internal diameters in systole (aMD -0.27 mm, 95% CI -0.45, -0.18) and diastole (aMD -0.37 mm, 95% CI -0.59, -0.09), reduced stroke volumes (aMD -0.36 mL, 95% CI -0.61, -0.11), and increased heart rates (aMD 3.14 bpm, 95% CI 1.10, 6.18) and mitral valve early peak velocities (aMD 2.17 cm/s, 95% CI 0.31, 4.04) than unexposed infants (N=24,639). Infants born to mothers with GDM (N=649) had significantly smaller LV internal diameters in systole (aMD -0.13 mm, 95% CI -0.22, -0.03) and similar structural and functional changes as children exposed to pre-existing diabetes, albeit with smaller, non-significant aMDs. Higher third-trimester HbA1c levels were associated with smaller LV internal diameters and stroke volumes among infants exposed to pre-existing diabetes and with lower heart rates among infants exposed to GDM.
Conclusion: Maternal pre-existing diabetes and, to a lesser extent, GDM were associated with changes in infant LV structure and function.