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Maternal diabetes and cardiac left ventricular structure and function in the infant:a Copenhagen Baby Heart Study

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posted on 2024-10-15, 19:57 authored by Jonas Ghouse, Magdalena Hansson, Ruth Ottilia B. Vøgg, Anne-Sophie Sillesen, Sofie Pærregaard, Anna Axelsson Raja, Niels Vejlstrup, Ruth Frikke-Schmidt, Nina Øyen, Aparna Kulkarni, Magnus T. Jensen, Finn Stener Jørgensen, Karin Sundberg, Olav B. Petersen, Jan Wohlfahrt, Peter Damm, Morten Salling Olesen, Elisabeth R. Mathiesen, Kasper Iversen, Henning Bundgaard, Heather A. Boyd

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.  

Funding

The CBHS has received financial support from the Danish Heart Association, the Danish Children’s Heart Foundation, Candy’s Foundation, the Toyota Foundation, the Herlev-Gentofte Hospital Research Foundation, and the Gangsted Foundation. Olav Bjørn Petersen holds a professorship funded by Novo Nordisk Foundation (grant NNFSA1700305769). The funders had no role in the design of the study; in the collection, analysis, or interpretation of data; in the writing of manuscripts; or in decisions to publish results.

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