Maternal gestational diabetes mellitus and the risk of subsequent pediatric cardiovascular diseases of the offspring: a population-based cohort study with up to 18 years of follow up
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The prevalence of gestational diabetes mellitus (GDM) has been increasing worldwide. We aimed to study the effect of GDM on the risk for childhood cardiovascular morbidity of the offspring.
A population-based cohort analysis was performed comparing total and different subtypes of cardiovascular related pediatric diagnoses among offspring of mothers with GDM vs. offspring of mothers with no diabetes. The analysis included all singletons born between the years 1991–2014. Cardiovascular related morbidities included hospitalizations involving a pre-defined set of ICD-9 codes. Mothers with pregestational diabetes, Infants with congenital malformations, multiple gestations, and perinatal deaths were excluded from the analysis. A Cox proportional hazards model was constructed to adjust for confounders.
The study population included 216197 newborns which met the inclusion criteria; among them 4.4% (9460) were born to mothers with GDM controlled by diet and exercise (GDM A1) and 0.3% (724) were born to mothers with GDM requiring oral treatment or insulin (GDM A2). A significant association was noted between GDM and the rate of cardiovascular related hospitalizations (0.97 for GDM A2 vs. 0.57 for GDM A1 vs. 0.33 for no GDM, respectively; p < 0.001). The association remained significant and independent for GDM A1 only while adjusting for relevant confounders [adjusted HR = 1.6 (1.2–2.2); p value 0.001].
A significant association is noted between the GDM and the rate of cardiovascular hospitalizations of the offspring. However, in our population GDM A1 is an independent risk factor for pediatric cardiovascular morbidity of the offspring.
KeywordsArrhythmia Cardiovascular disorders Diabetes Epigenetics Endocrinology Hyperglycemia Hypertension
NL, MD wrote the first draft of the manuscript.
This study was not funded. No honorarium, grant, or other form of payment was given to anyone to produce the manuscript.
Compliance with ethical standards
Conflict of interest
The authors report no conflict of interest.
The study received the approval of the Institutional Review Board Committee of the Soroka University Medical Center (SUMC IRB).
For this type of study formal consent is not required.
- 5.Ferrara A, Weiss NS, Hedderson MM et al (2007) Pregnancy plasma glucose levels exceeding the American Diabetes Association thresholds, but below the National Diabetes Data Group thresholds for gestational diabetes mellitus, are related to the risk of neonatal macrosomia, hypoglycaemia and hyperbilirubinaemia. Diabetologia 50:298CrossRefPubMedGoogle Scholar
- 16.Statistics TCBo. Israel in Figs. 2013. http://www.cbs.gov.il/www/publications/isr_in_n13e.pdf. Accessed 25 May 2015