No effect of gestational diabetes or pre-gestational obesity on 6-year offspring left ventricular function-RADIEL study follow-up

Acta Diabetol. 2020 Dec;57(12):1463-1472. doi: 10.1007/s00592-020-01571-z. Epub 2020 Jul 28.

Abstract

Aims: We aimed to investigate associations between pre-pregnancy obesity, gestational diabetes (GDM), offspring body composition, and left ventricular diastolic and systolic function in early childhood.

Methods: This is an observational study, including 201 mother-child pairs originating from the Finnish Gestational Diabetes Prevention Study (RADIEL; 96 with GDM, 128 with pre-pregnancy obesity) with follow-up from gestation to 6-year postpartum. Follow-up included dyads anthropometrics, body composition, blood pressure, and child left ventricular function with comprehensive echocardiography (conventional and strain imaging).

Results: Offspring left ventricular diastolic and systolic function was not associated with gestational glucose concentrations, GDM, or pregravida obesity. Child body fat percentage correlated with maternal pre-pregnancy BMI in the setting of maternal obesity (r = 0.23, P = 0.009). After adjusting for child lean body mass, age, sex, systolic BP, resting HR, maternal lean body mass, pre-gestational BMI, and GDM status, child left atrial volume increased by 0.3 ml (95% CI 0.1, 0.5) for each 1% increase in child body fat percentage.

Conclusions: No evidence of foetal cardiac programming related to GDM or maternal pre-pregnancy obesity was observed in early childhood. Maternal pre-pregnancy obesity is associated with early weight gain. Child adiposity in early childhood is independently associated with increased left atrial volume, but its implications for long-term left ventricle diastolic function and cardiovascular health remain unknown.

Keywords: Cardiovascular disease; Child; Developmental biology; Gestational diabetes mellitus; Obesity; Ventricular function.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Adult
  • Body Mass Index
  • Child
  • Child of Impaired Parents* / statistics & numerical data
  • Child, Preschool
  • Diabetes, Gestational*
  • Female
  • Finland / epidemiology
  • Follow-Up Studies
  • Heart Ventricles / diagnostic imaging
  • Humans
  • Longitudinal Studies
  • Male
  • Obesity*
  • Pregnancy
  • Prenatal Exposure Delayed Effects / diagnostic imaging
  • Prenatal Exposure Delayed Effects / epidemiology
  • Prenatal Exposure Delayed Effects / physiopathology
  • Randomized Controlled Trials as Topic / statistics & numerical data
  • Risk Factors
  • Ventricular Function, Left / physiology*