P172 - THE IMPACT OF GESTATIONAL DIABETES ON THE CARDIOVASCULAR HEALTH OF THE CHILD

Friday, October 28, 2022

3:50 PM – 4:00 PM EDT

Location: Room 201

Presenter(s)

Cleighton R. Boehme, BSc

Medical Student
University of Alberta
Edmonton, Alberta, Canada

First Author(s)

Cleighton R. Boehme, BSc

Medical Student
University of Alberta
Edmonton, Alberta, Canada

Author(s)

Martha M. Moran

Clinical Fellow
Stollery Children's Hospital
University of Alberta
Edmonton, Alberta, Canada
VD

Victor Do

Toronto, Ontario, Canada
JL

Juliana Lasso-Mendez

MSc student
Edmonton, Alberta, Canada
RB

Rhonda C. Bell, PhD

Professor
Edmonton, Newfoundland and Labrador, Canada
Deborah Fruitman (she/her/hers)

Clinical Associate Professor
CPCA
University of Calgary
Calgary, Alberta, Canada

Senior Author(s)

Lisa K. Hornberger, MD

Professor of Pediatrics/Obstetrics & Gynecology
CPCA
University of Alberta
Edmonton, Alberta, Canada

Supervisor(s)

Lisa K. Hornberger, MD

Professor of Pediatrics/Obstetrics & Gynecology
CPCA
University of Alberta
Edmonton, Alberta, Canada

Background: There is increasing evidence that fetal exposures influence lifelong cardiovascular (CV) health. Gestational diabetes mellitus (GDM) represents one such exposure that influences both the short- and long-term health of offspring, but the extent to which changes in CV structure and function are present in exposed children has not been fully investigated. In the present study, we explored the CV health of children (CGDM) of mothers who developed GDM compared to children of mothers without GDM in pregnancy.

METHODS AND RESULTS: This represents a nested case-control study, tied to the Alberta Pregnancy Outcomes and Nutrition (APrON) Cohort Study. Healthy CGDMs born at >36 weeks of gestation to GDM mothers and age- and sex-matched children born to healthy mothers with uncomplicated pregnancies were identified and invited to undergo CV assessments. Outcome measures included LV mass Z-score (Devereaux method, normalized for lean body mass), EndoPAT reactive hyperemia index score (normalized; LnRHI), Doppler based aortic (proximal to distal aortic arch; aPWV) and peripheral (common carotid to posterior tibial artery; pPWV) pulse wave velocity, and carotid intima-media thickness (cIMT). CGDMs were further stratified into groups according to how maternal GDM was controlled (diet alone or insulin). Participants were 25 CGDMs and 28 control children at a mean age of 10.9±0.7 years. aPWV was higher in CGDMs versus controls (6.2±2.6 versus 4.8±1.6 m/s, P=0.03), and higher in children of insulin versus diet controlled GDM (7.9±2.6 versus 5.5±2.2 m/s, P=0.03) (see Table). There were no statistically significant differences in the other measures of CV health.

Conclusion: CGDMs demonstrate increased aPWV, a measure of aortic stiffness, with greater aPWV observed in CGDMs whose mothers’ glycemic control was through insulin therapy versus diet. These findings suggest GDM could influence vascular health early in life which may impact myocardial health in adulthood. Whether other prenatal and postnatal insults are contributory is under investigation. Additional work is needed to investigate the mechanisms by which GDM may influence vascular health.