Maternal Overweight and Obesity and Risk of Congenital Heart Defects

Persson, Martina; Razaz, Neda; Bonamy, Anna Karin Edstedt; Villamor, Eduardo; Cnattingius, Sven

doi:10.1016/j.jacc.2018.10.050

Cited by 102 publications

(111 citation statements)

References 51 publications

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“…One study reported that the risk of congenital heart disease was higher among offspring exposed to pregestational diabetes than among those exposed to gestational diabetes 18. A Swedish study found that pregestational and gestational diabetes were associated with congenital heart defects 42. In our large study, we found increased rates of early onset CVD in offspring prenatally exposed to three types of maternal diabetes (pregestational type 1 and type 2, and gestational diabetes).…”

Section: Discussionsupporting

confidence: 47%

“…Empirical evidence is lacking for an association of maternal diabetes during pregnancy with the overall risk of early onset CVD in offspring, with the exception of an increased risk of congenital heart diseases 1842. One study reported that the risk of congenital heart disease was higher among offspring exposed to pregestational diabetes than among those exposed to gestational diabetes 18.…”

Section: Discussionmentioning

confidence: 99%

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Maternal diabetes during pregnancy and early onset of cardiovascular disease in offspring: population based cohort study with 40 years of follow-up

Arah

Liew

et al. 2019

BMJ

Self Cite

202

170

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ObjectiveTo evaluate the associations between maternal diabetes diagnosed before or during pregnancy and early onset cardiovascular disease (CVD) in offspring during their first four decades of life.DesignPopulation based cohort study.SettingDanish national health registries.ParticipantsAll 2 432 000 liveborn children without congenital heart disease in Denmark during 1977-2016. Follow-up began at birth and continued until first time diagnosis of CVD, death, emigration, or 31 December 2016, whichever came first.Exposures for observational studiesPregestational diabetes, including type 1 diabetes (n=22 055) and type 2 diabetes (n=6537), and gestational diabetes (n=26 272).Main outcome measuresThe primary outcome was early onset CVD (excluding congenital heart diseases) defined by hospital diagnosis. Associations between maternal diabetes and risks of early onset CVD in offspring were studied. Cox regression was used to assess whether a maternal history of CVD or maternal diabetic complications affected these associations. Adjustments were made for calendar year, sex, singleton status, maternal factors (parity, age, smoking, education, cohabitation, residence at childbirth, history of CVD before childbirth), and paternal history of CVD before childbirth. The cumulative incidence was averaged across all individuals, and factors were adjusted while treating deaths from causes other than CVD as competing events.ResultsDuring up to 40 years of follow-up, 1153 offspring of mothers with diabetes and 91 311 offspring of mothers who did not have diabetes were diagnosed with CVD. Offspring of mothers with diabetes had a 29% increased overall rate of early onset CVD (hazard ratio 1.29 (95% confidence interval 1.21 to 1.37); cumulative incidence among offspring unexposed to maternal diabetes at 40 years of age 13.07% (12.92% to 13.21%), difference in cumulative incidence between exposed and unexposed offspring 4.72% (2.37% to 7.06%)). The sibship design yielded results similar to those of the unpaired design based on the whole cohort. Both pregestational diabetes (1.34 (1.25 to 1.43)) and gestational diabetes (1.19 (1.07 to 1.32)) were associated with increased rates of CVD in offspring. We also observed varied increased rates of specific early onset CVDs, particularly heart failure (1.45 (0.89 to 2.35)), hypertensive disease (1.78 (1.50 to 2.11)), deep vein thrombosis (1.82 (1.38 to 2.41)), and pulmonary embolism (1.91 (1.31 to 2.80)). Increased rates of CVD were seen in different age groups from childhood to early adulthood until age 40 years. The increased rates were more pronounced among offspring of mothers with diabetic complications (1.60 (1.25 to 2.05)). A higher incidence of early onset CVD in offspring of mothers with diabetes and comorbid CVD (1.73 (1.36 to 2.20)) was associated with the added influence of comorbid CVD but not due to the interaction between diabetes and CVD on the multiplicative scale (P value for interaction 0.94).ConclusionsChildren of mothers with diabetes, especially those mothers with a...

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Section: Discussionsupporting

confidence: 47%

Section: Discussionmentioning

confidence: 99%

Maternal diabetes during pregnancy and early onset of cardiovascular disease in offspring: population based cohort study with 40 years of follow-up

Arah

Liew

et al. 2019

BMJ

Self Cite

202

170

View full text Add to dashboard Cite

show abstract

“…In addition to causing maternal conditions, maternal obesity is also associated with both LGA and PTD [21]. This cluster of comorbidity may also include a causal connection between maternal obesity and cyanotic congenital heart disease [25][26][27] and the treatment sequelae [28]. Racial health disparities for birth defects among children of NHOPI women have been reported but the risks were estimated relative to non-Hispanic white women and their children and the risk was adjusted for maternal age without a reporting of the mediation effect of maternal age [13,14].…”

Section: Discussionmentioning

confidence: 99%

Estimating racial health disparities among adverse birth outcomes as deviations from the population rates

Thompson

Suter

2020

BMC Pregnancy Childbirth

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Background: Despite significant research, the reasons for racial health disparities among adverse birth outcomes (ABO) remain largely unknown. The bulk of research into racial health disparities among ABO in the United States has concentrated on the risk of race and ethnic groups relative to the specific sub-population of non-Hispanic white women and their children. The objective of this study was to estimate the racial and ethnic risks among a set of neonatal and maternal health disparities while minimizing bias attributable to how the baseline risk was established. Methods: All birth records were obtained from the United States Natality database for the years 2014 to 2017. A Bayesian modeling approach was used to estimate the risk disparity for disorders by race. The estimation of the racespecific risks used a sum-to-zero constraint for the race regression coefficients. Results: Estimating racial health disparities relative to the overall population rate yielded novel results and identified perinatal health disparities for all the race groups studied. Conclusions: Unbiased risk estimates for racial disparities among ABO are now available for stimulating and initiating more complex causal modeling that can lead to understanding how racial health disparities for ABO are mediated and how they can be prevented.

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“…Maternal overweight and obesity is a public health challenge and contributes to adverse health outcomes for both mother [1,2] and infant [3][4][5]. During the past decade, there has been a greater increase in average body mass index (BMI) among women in Southeast Asia (>1 kg/m 2 ) than those residing in higher-income Asian countries (<0.2 kg/m 2 ) [6].…”

Section: Introductionmentioning

confidence: 99%

Postpartum Physical Activity and Weight Retention within One Year: A Prospective Cohort Study in Vietnam

Zhao

Binns

et al. 2020

IJERPH

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After delivery, mothers are encouraged to increase physical activity (PA) gradually to regulate body weight; however, data on PA in relation to postpartum weight retention remains scarce, particularly among Asian women. In a cohort of 1617 Vietnamese mothers, we investigated the prospective association between habitual PA exposures at 3-month postpartum and weight retention at 6-month and 12-month postpartum. Detailed information on PA intensity and domains was collected from participants using a validated instrument specifically for Vietnamese women. Linear regression analyses and a general linear model for the repeated weight retention measures were used to ascertain the apparent relationships. On average, the participants reported 3.6 (SD 3.9) and 2.6 (SD 3.8) kg weight loss at 6-and 12-month postpartum, respectively. Total and light-intensity PA were inversely associated with the postpartum weight retention (p for trend <0.05). Our findings highlight the importance of resuming PA in the early postpartum period as an appropriate weight management strategy.

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Maternal Overweight and Obesity and Risk of Congenital Heart Defects

Cited by 102 publications

References 51 publications

Maternal diabetes during pregnancy and early onset of cardiovascular disease in offspring: population based cohort study with 40 years of follow-up

Maternal diabetes during pregnancy and early onset of cardiovascular disease in offspring: population based cohort study with 40 years of follow-up

Estimating racial health disparities among adverse birth outcomes as deviations from the population rates

Postpartum Physical Activity and Weight Retention within One Year: A Prospective Cohort Study in Vietnam

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