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Infants with macrosomia and infants of diabetic mothers have increased carotid artery intima-media thickness in childhood

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Abstract

Incidence of diabetes during pregnancy is increasing worldwide, and intrauterine hyperglycemia exposure may have long-term adverse effects on the cardiovascular health of children. We investigated prospectively the risk of atherosclerosis and carotid intima-media thickness (CIMT) in infants born macrosomic and in infants of diabetic mothers (IDM) at the age of 8–9 years in 2021. A total of 49 infants of diabetic mothers (IDM group) and 13 macrosomic infants (macrosomic group) were included in the study. They were compared with 26 age-matched healthy children with birth weight appropriate for gestational age born to non-diabetic mothers (control group). Anthropometric measurements, atherosclerosis risk factors, and CIMT measurements were performed. There was no significant difference between the groups in terms of age, gender, actual anthropometric measurements, blood pressure measurements, laboratory parameters, or atherosclerosis risk factors. Gestational age was lower in the IDM group (p < 0.001), while birth weight was higher in the macrosomic group (p < 0.001). High-density lipoprotein cholesterol level was lower in the IDM group than the other groups. Duration of exclusive and total breastfeeding was lower in IDM group than in the control group (p < 0.001 for both). Body mass index, skinfold thickness, waist-to-hip ratio, and waist-to-height ratio were higher in those breastfed for less than 6 months in the IDM group. The CIMT values were statistically higher in IDM [0.43 ± 0.047 (0.34–0.60)] and macrosomic [0.40 ± 0.055 (0.33–0.50)] groups than control group [0.34 ± 0.047 (0.26–0.45)].

Conclusion: CIMT values were higher in IDM and macrosomic groups at 8–9 years old age compared to children born with normal birth weight. This indicates intrauterine exposure in both groups. And also, breastfeeding seems very important for IDMs.

What is Known:

• Intrauterine hyperglycemia exposure has long-term adverse effects on the cardiovascular health of children.

• Infants of diabetic mothers have higher carotid artery intima-media thickness at birth.

What is New:

• Both infants of diabetic mothers and infants with macrosomia have increased carotid artery intima-media thickness at the age of 8-9 years.

• Duration of breast feeding is important especially in infants of diabetic mothers as body mass index, skinfold thickness, waist to hip and height ratio were higher in those breastfed less than 6 months.

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Abbreviations

BMI:

Body mass index

BP:

Blood pressure

CIMT:

Carotid intima-media thickness

CVD:

Cardiovascular diseases

DM:

Diabetes mellitus

FPG:

Fasting plasma glucose

GDM:

Gestational diabetes mellitus

HAPO:

Hyperglycemia and Adverse Pregnancy Outcome

HDL:

High-density lipoprotein

IDM:

Infants of diabetic mothers

LDL:

Low-density lipoprotein

TC:

Total cholesterol

TG:

Triglyceride

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Funding

The study was funded by Cukurova University 2021, TTU-13484.

Author information

Authors and Affiliations

  1. Faculty of Medicine, Division of Neonatology, Department of Pediatrics, Cukurova University, 01330, Adana, Turkey

    H. Yapicioglu & S. C. Seckin

  2. Faculty of Medicine, Division of Pediatric Intensive Care, Department of Pediatrics, Cukurova University, 01330, Adana, Turkey

    A. Yontem & D. Yildizdas

Authors
  1. H. Yapicioglu
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  2. S. C. Seckin
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Contributions

Hacer Yapicioglu and Ceren Seckin: investigation, writing, original draft preparation, and editing; Ahmet Yontem: investigation, ultrasound examinations, and statistical analysis; Dincer Yildizdas: investigation and editing. All authors agree to all aspects of the work and approved the final manuscript.

Corresponding author

Correspondence to H. Yapicioglu.

Ethics declarations

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. The study was approved by Çukurova University Ethics Committee (Date: October 4, 2019, Decision No.: 30).

Consent to participate

Written informed consent was obtained from the parents.

Competing interests

The authors declare no competing interests and agree to all aspects of the work and approved the final manuscript.

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Communicated by Daniele De Luca

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Highlights

1. Both infants with macrosomia and infants of diabetic mothers have increased carotid artery intima-media thickness at 8–9 years old age.

2. Duration of exclusive breastfeeding and duration of total breastfeeding were lower in the infants of diabetic mothers.

3. Body mass index, skinfold thickness, waist-to-hip ratio, and waist-to-height ratio were higher in those breastfed for less than 6 months in the infants of diabetic mothers group.

H. Yapicioglu and S.C. Seckin share the same responsibility for the manuscript.

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Yapicioglu, H., Seckin, S.C., Yontem, A. et al. Infants with macrosomia and infants of diabetic mothers have increased carotid artery intima-media thickness in childhood. Eur J Pediatr 182, 203–211 (2023). https://doi.org/10.1007/s00431-022-04653-y

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  • DOI: https://doi.org/10.1007/s00431-022-04653-y

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