Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland.
Department of Epidemiology and Health Services, Center for Primary Care and Public Health (UNISANTÉ), University of Lausanne, Lausanne, Switzerland.
BMJ Open. 2022 Jul 26;12(7):e061649. doi: 10.1136/bmjopen-2022-061649.
Hyperglycaemia during pregnancy is associated with cardiometabolic risks for the mother and the offspring. Mothers with gestational diabetes mellitus (GDM) have signs of subclinical atherosclerosis, including increased carotid intima-media thickness (CIMT). We assessed whether GDM is associated with increased CIMT in the offspring at birth.
MySweetHeart Cohort is a prospective cohort study conducted in Switzerland.
PARTICIPANTS, EXPOSURE AND OUTCOME MEASURES: This work included pregnant women with and without GDM at 24-32 weeks of gestation and their singleton live-born offspring with data on the primary outcome of CIMT. GDM was diagnosed based on the criteria of the International Association of Diabetes and Pregnancy Study Groups. Offspring's CIMT was measured by ultrasonography after birth (range 1-19 days).
Data on CIMT were available for 99 offspring of women without GDM and 101 offspring of women with GDM. Maternal age ranged from 18 to 47 years. Some 16% of women with GDM and 6% of women without GDM were obese. Smoking during pregnancy was more frequent among women with GDM (18%) than among those without GDM (4%). Neonatal characteristics were comparable between the two groups. The difference in CIMT between offspring of women with and without GDM was of 0.00 mm (95% CI -0.01 to 0.01; p=0.96) and remained similar on adjustment for potential confounding factors, such as maternal prepregnancy body mass index, maternal education, smoking during pregnancy, family history of diabetes, as well as offspring's sex, age, and body surface area (0.00 mm (95% CI -0.02 to 0.01; p=0.45)).
We found no evidence of increased CIMT in neonates exposed to GDM. A longer-term follow-up that includes additional vascular measures, such as endothelial function or arterial stiffness, may shed further light on the cardiovascular health trajectories in children born to mothers with GDM.
NCT02872974; Pre-results.
孕期高血糖与母婴的心血管代谢风险相关。患有妊娠期糖尿病(GDM)的母亲存在亚临床动脉粥样硬化的迹象,包括颈动脉内膜中层厚度(CIMT)增加。我们评估了 GDM 是否与新生儿出生时 CIMT 增加有关。
MySweetHeart 队列是在瑞士进行的一项前瞻性队列研究。
参与者、暴露和结局测量:本研究纳入了妊娠 24-32 周时患有和不患有 GDM 的孕妇及其单胎活产新生儿,并记录了 CIMT 这一主要结局的相关数据。GDM 的诊断基于国际妊娠糖尿病研究协会的标准。新生儿的 CIMT 在出生后通过超声测量(范围 1-19 天)。
共纳入 99 名无 GDM 孕妇的新生儿和 101 名有 GDM 孕妇的新生儿的数据。产妇年龄为 18-47 岁。约 16%的 GDM 孕妇和 6%的无 GDM 孕妇肥胖。GDM 孕妇的吸烟率(18%)高于无 GDM 孕妇(4%)。两组新生儿特征相似。GDM 孕妇的新生儿与无 GDM 孕妇的新生儿的 CIMT 差异为 0.00mm(95%CI-0.01 至 0.01;p=0.96),调整了母体孕前体重指数、教育程度、孕期吸烟、糖尿病家族史以及新生儿性别、年龄和体表面积等潜在混杂因素后,差异仍相似(0.00mm(95%CI-0.02 至 0.01;p=0.45))。
我们没有发现暴露于 GDM 的新生儿 CIMT 增加的证据。更长时间的随访,包括内皮功能或动脉僵硬等额外的血管指标,可能进一步揭示 GDM 母亲所生儿童的心血管健康轨迹。
NCT02872974;预注册结果。