Gestational diabetes exposure tied to higher cholesterol, BP in children
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Exposure to gestational diabetes in utero is associated with worse cardiovascular health in offspring from childhood through adolescence, according to an analysis of health plan data published in Pediatric Obesity.
“The prevention of maternal gestational diabetes can improve offspring cardiovascular outcomes,” Wei Perng, MPH, PhD, assistant professor of epidemiology and assistant director of the Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center at the Colorado School of Public Health, University of Colorado Denver Anschutz Medical Campus, told Healio. “It is important to identify viable and effective methods of preventing gestational diabetes. This has proved challenging, and it is likely that a more nuanced understanding of mechanisms linking maternal gestational diabetes to poor cardiovascular outcomes in offspring is needed.”
Perng and colleagues analyzed data from 597 youths with at least one CV risk factor of interest whose mothers were members of the Kaiser Permanente of Colorado health plan (50% girls; 48.1% white). Within the cohort, 92 mothers had a diagnosis of gestational diabetes. Researchers used mixed-effects linear regression models to examine associations of maternal gestational diabetes with average offspring levels of serum lipids (total cholesterol, HDL and LDL cholesterol, and triglycerides) and systolic blood pressure across two research visits (mean age at visits, 11 and 17 years; mean follow-up time, 6 years). In sex-stratified analyses, researchers also evaluated the influence of sociodemographic characteristics, pubertal status, physical activity and total energy intake, maternal BMI, gestational diabetes treatment and offspring BMI.
Compared with unexposed girls, gestational diabetes exposure was associated with higher total cholesterol (mean, 0.38 mmol/L; 95% CI, 0.16-0.61) and higher LDL cholesterol (mean, 0.34 mmol/L; 95% CI, 0.14-0.53) among girls. Adjustment for gestational diabetes treatment attenuated both estimates by approximately two-thirds the magnitude, according to researchers.
Among boys, exposure to gestational diabetes was associated with an average 4.5 mm Hg higher systolic BP compared with boys not exposed to gestational diabetes (95% CI, 1.9-7.1), with results persisting after adjustment for sociodemographic and lifestyle factors, maternal BMI, and gestational diabetes treatment. The association for boys was attenuated by approximately 30% after adjusting for current BMI, according to researchers.
“In girls, gestational diabetes was associated with higher total cholesterol and LDL [cholesterol],” the researchers wrote. “In boys, gestational diabetes corresponded with consistently higher systolic BP. These associations were consistent across the age-range studied and did not change over time.”
The researchers noted that the effect sizes detected are modest; however, they may have important long-term ramifications given that cardiometabolic risk factors track from childhood into adulthood and are independent predictors of CV risk. – by Regina Schaffer
For more information:
Wei Perng, MPH, PhD, can be reached at Colorado School of Public Health, University of Colorado Denver, Anschutz Medical Campus, 12474 E. 19th Ave., Room 208, Aurora, CO 80045; email: wei.perng@cuanschutz.edu.
Disclosures: The authors report no relevant financial disclosures.
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