Is the child at risk? Cardiovascular remodelling in children born to diabetic mothers

Hoodbhoy, Zahra; Mohammed, Nuruddin; Aslam, Nadeem; Fatima, Urooj; Ashiqali, Salima; Rizvi, Arjumand; Pascua, Christine; Chowdhury, Devyani; Hasan, Babar

doi:10.1017/s1047951119000040

Cited by 9 publications

(8 citation statements)

References 35 publications

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“…The difference is largely found in combination-exposed males and associated with higher mortality (Figure S1). Like in human infants born to diabetic mothers, cardiac mass normalizes after birth (El-Ganzoury et al, 2012;Garg et al, 2014;Hoodbhoy et al, 2019) with no apparent differences from 3WK to 6MO. In normal females, heart weight increases steadily up to 12MO, but diabetes-exposed females lose 20% of heart mass from 6 to 12MO (p = 0.019).…”

Section: In Utero Exposure To Maternal Glucolipotoxicity Increases Offspring Mortality Even When Newborns Are Reared By Normal Mothersmentioning

confidence: 85%

Age and Sex Influence Mitochondria and Cardiac Health in Offspring Exposed to Maternal Glucolipotoxicity

et al. 2020

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Infants of diabetic mothers are at risk of cardiomyopathy at birth and myocardial infarction in adulthood, but prevention is hindered because mechanisms remain unknown. We previously showed that maternal glucolipotoxicity increases the risk of cardiomyopathy and mortality in newborn rats through fuel-mediated mitochondrial dysfunction. Here we demonstrate ongoing cardiometabolic consequences by cross-fostering and following echocardiography, cardiomyocyte bioenergetics, mitochondria-mediated turnover, and cell death following metabolic stress in aged adults. Like humans, cardiac function improves by weaning with no apparent differences in early adulthood but declines again in aged diabetesexposed offspring. This is preceded by impaired oxidative phosphorylation, exaggerated age-related increase in mitochondrial number, and higher oxygen consumption. Prenatally exposed male cardiomyocytes have more mitolysosomes indicating high baseline turnover; when exposed to metabolic stress, mitophagy cannot increase and cardiomyocytes have faster mitochondrial membrane potential loss and mitochondria-mediated cell death. Details highlight age-and sex-specific roles of mitochondria in developmentally programmed adult heart disease.

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Section: In Utero Exposure To Maternal Glucolipotoxicity Increases Offspring Mortality Even When Newborns Are Reared By Normal Mothersmentioning

confidence: 85%

Age and Sex Influence Mitochondria and Cardiac Health in Offspring Exposed to Maternal Glucolipotoxicity

et al. 2020

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“…Birth weight was significantly higher in the GDM group when compared to nonexposed controls (MD: 0.12 kg; 95% CI: 0.06–0.18; 25 studies; 62,679 participants; Fig. 3 ), 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 but there was no statistical difference in the mean body weight at the time of assessment (MD: 0.1 kg; 95% CI: −0.24 to 0.43; 8 studies; 2,762 participants) 24 32 41 45 49 51 54 56 and BMI (MD: 0.79 kg/m 2 ; 95% CI: −0.08 to 1.65; 9 studies; 2,958 participants). 32 38 41 43 51 54 56 57 58…”

Section: Resultsmentioning

confidence: 97%

“…The literature search identified 6,376 studies after de-duplication, of which 45 studies 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 were included for the systematic review and 40 studies included in the meta-analysis ( Fig. 1 ).…”

Section: Resultsmentioning

confidence: 99%

The Impact of Maternal Preeclampsia and Hyperglycemia on the Cardiovascular Health of the Offspring: A Systematic Review and Meta-analysis

et al. 2021

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Objectives The objective of this review was to assess the impact of maternal preeclampsia or hyperglycemia on the body composition and cardiovascular health in the offspring. Study Design We conducted a systematic review utilizing PubMed, EBSCO, CINAHLPlus, Cochrane Library, and Web of Science to include all studies assessing the impact of preeclampsia/eclampsia and/or gestational/pregestational diabetes mellitus on the health of the offspring (children <10 years of age). The health measures included anthropometry, cardiac dimensions and function, and vascular function. We performed a meta-analysis using Review Manager software and computed net risk ratio (RR) with 95% confidence interval (CI) for dichotomous data and mean difference (MD) with 95% CI for continuous data. Results There were 6,376 studies in total, of which 45 were included in the review and 40 in the meta-analysis. The results demonstrated higher birth weight (MD: 0.12 kg; 95% CI: 0.06–0.18) and systolic and diastolic blood pressure (BP; MD: 5.98 mmHg; 95% CI: 5.64–6.32 and MD: 3.27 mmHg; 95% CI: 0.65–5.89, respectively) in the offspring of mothers with gestational diabetes compared to controls. In contrast, the offspring of mothers with preeclampsia had lower birth weight (MD: −0.41 kg; 95% CI: −0.7 to −0.11); however, they had increased systolic (MD: 2.2 mmHg; 95% CI: 1.28–3.12) and diastolic BP (MD: 1.41 mmHg; 95% CI: 0.3–2.52) compared to controls. There is lack of data to conduct a meta-analysis of cardiac morphology, functional, and vascular imaging parameters. Conclusion These findings suggest that the in-utero milieu can have a permanent impact on the body composition and vascular health of the offspring. Future work warrants multicenter prospective studies to understand the mechanism and the actual effect of exposure to maternal hyperglycemia and high BP on the cardiovascular health of the offspring and long-term outcomes. Key Points

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“…Four studies performed measurements in the first 1–6 months of life ( 5 , 25 , 26 , 36 ). Seven studies performed measurements on children at the age of 2–8 years ( 6 , 7 , 39 , 41 – 44 ). Three studies performed repeated measurements in the first week of life and at 1–6 months ( 5 , 26 , 36 ), and one study repeated measurements two times at 1–8 years ( 44 ).…”

Section: Resultsmentioning

confidence: 99%

Diabetes in pregnancy and offspring cardiac function: a systematic review and meta-analysis

Skovsgaard,

Møller,

Bjerre

et al. 2024

Front. Pediatr.

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IntroductionDiabetes in pregnancy is associated with impaired offspring cardiac function. The objective of this systematic review was to determine the effect of diabetes in pregnancy on cardiac function in the offspring measured by echocardiography.MethodsPubMed, Embase, Cochrane CENTRAL and Web of Science databases were searched from 1992 to June 27, 2023. Studies reporting offspring (age < 18 years) cardiac function by echocardiography compared between any type of diabetes in pregnancy and healthy control pregnancies were included. Study selection, quality assessment and risk of bias was independently performed by two reviewers. Meta-analyses was performed where possible.ResultsThirty-one observational studies were included 1,679 cases and 2,694 controls. In the first week of life (23 studies, n = 2,663), intraventricular septum diastolic diameter (hypertrophy) was increased, while myocardial performance index (global function) and LV E/A-ratio (diastolic function) were decreased. No difference was found for left ventricular ejection fraction (systolic function). At 1–6 months (4 studies, n = 454) studies found hypertrophy, and decreased global function, but no difference in systolic or diastolic function. At 1–8 years (7 studies, n = 1,609) no difference was found. The available data did not allow for sub-analysis based on the type of diabetes, treatment, or glycemic control.ConclusionsDiabetes in pregnancy is associated with cardiac hypertrophy and impaired global cardiac function in infants up to six months old. The few studies reporting on older children found no difference in the parameters investigated. Longitudinal studies employing more advanced echocardiographic measures or MRI are needed to evaluate consequences for long-term cardiac health.Systematic Review Registrationhttps://www.crd.york.ac.uk/, identifier (CRD42022312471).

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Is the child at risk? Cardiovascular remodelling in children born to diabetic mothers

Cited by 9 publications

References 35 publications

Age and Sex Influence Mitochondria and Cardiac Health in Offspring Exposed to Maternal Glucolipotoxicity

Age and Sex Influence Mitochondria and Cardiac Health in Offspring Exposed to Maternal Glucolipotoxicity

The Impact of Maternal Preeclampsia and Hyperglycemia on the Cardiovascular Health of the Offspring: A Systematic Review and Meta-analysis

Diabetes in pregnancy and offspring cardiac function: a systematic review and meta-analysis

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