No effect of gestational diabetes or pre-gestational obesity on 6-year offspring left ventricular function\u2014RADIEL study follow-up

Linda Litwin,Kristiina Rönö,Taisto Sarkola,Saila B Koivusalo,Johnny K M Sundholm,Johan G Eriksson

doi:10.1007/s00592-020-01571-z

Abstract

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

Highlights

Maternal hyperglycaemia affects foetal development and results in increased newborn morbidity, including macrosomia, left ventricle (LV) hypertrophy, and diastolic dysfunction even in optimally treated pregnancies [1,2,3]
We have found that maternal pregravida obesity, but not gestational diabetes mellitus (GDM) was associated with offspring early vascular structure changes, but neither had the effect on child LV mass in early childhood [9, 10]
We have previously published on associations between GDM and maternal/child adiposity and child LV mass [10], and in this manuscript, we focused on LV mass relations with LV diastolic function

Summary

Introduction

Maternal hyperglycaemia affects foetal development and results in increased newborn morbidity, including macrosomia, left ventricle (LV) hypertrophy, and diastolic dysfunction even in optimally treated pregnancies [1,2,3]. Extended author information available on the last page of the article associated with an early offspring weight gain and predict increased adiposity and unfavourable cardiometabolic risk profiles later in life [4, 5]. Apart from foetal development, LV myocardial relaxation can be affected by child growth and health behaviours, including the obesity-related functional decline observed in adolescents [8]. Acta Diabetologica (2020) 57:1463–1472 intrauterine cardiovascular development attributed to maternal obesity and GDM could manifest as myocardial dysfunction later in life is largely unknown. We aim to investigate associations between maternal prepregnancy obesity, GDM, offspring body composition, and LV diastolic and systolic function. Maternal pre-pregnancy BMI was based on measured or declared weight and measured height

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Compliance with ethical standards