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

Abstract

Purpose: 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 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. Method: 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.Results: There was no signi cant 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 were lower in IDM group than in 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. This indicates intrauterine exposure in both groups. Breastfeeding seems very important for IDMs.

The impact of macrosomia on cardiometabolic health in preteens: findings from the ROLO longitudinal birth cohort study

“…The pathophysiology linking high birthweight and cardiometabolic risk in later life remains unknown, highlighting the importance of this research. Based on previous research, we expected that early precursors of obesity and cardiometabolic disease would be evident in youth born with macrosomia at 9–11 years of age [ 20 , 24 , 25 ]. Despite this, the prevalence of overweight and obesity in this preteen cohort did not differ between groups and was similar to an unselected cohort of similar age from the Growing Up in Ireland study [ 48 ].…”

“…Alternative assessment by echocardiography may also provide clearer results. Recently, Yapicioglu et al [ 24 ] found 8–9-year-olds born with macrosomia have higher carotid intima-media thickness levels than those born without macrosomia.…”