TY - JOUR
T1 - Is the child at risk? Cardiovascular remodelling in children born to diabetic mothers
AU - Hoodbhoy, Zahra
AU - Mohammed, Nuruddin
AU - Aslam, Nadeem
AU - Fatima, Urooj
AU - Ashiqali, Salima
AU - Rizvi, Arjumand
AU - Pascua, Christine
AU - Chowdhury, Devyani
AU - Hasan, Babar S.
N1 - Publisher Copyright:
© Cambridge University Press 2019.
PY - 2019/4/1
Y1 - 2019/4/1
N2 - Objective: The objective of this study was to assess differences in myocardial systolic and diastolic function and vascular function in children 2-5 years of age born to diabetic as compared to non-diabetic mothers.Methods: This study was a retrospective cohort conducted in 2016 at The Aga Khan University Hospital, Karachi, Pakistan. It included children between 2 and 5 years of age born to mothers with and without exposure to diabetes in utero (n = 68 in each group) and who were appropriate for gestational age. Myocardial morphology and function using echocardiogram and carotid intima media thickness (cIMT) and pulse wave velocity was performed to evaluate cardiac function as well as macrovascular remodelling in these children. Multiple linear regression was used to compare the groups.Results: There was no significant difference in cardiac morphology, myocardial systolic and diastolic function, and macrovascular assessment between the exposed and unexposed groups of AGA children. Subgroup analysis demonstrated a significantly decreased mitral E/A ratio in children whose mothers were on medications as compared to those on dietary control (median [IQR] = 1.7 [1.6-1.9] and 1.56 [1.4-1.7], respectively, p = 0.02), and a higher cIMT in children whose mothers were on medication as compared to controls (0.48 [0.44-0.52] and 0.46 [0.44-0.50], respectively, p = 0.03).Conclusion: In utero exposure to uncontrolled maternal diabetes has an effect on the cardiovascular structure and function in children aged 2-5 years. However, future work requires long-term follow-up from fetal to adult life to assess these changes over the life course.
AB - Objective: The objective of this study was to assess differences in myocardial systolic and diastolic function and vascular function in children 2-5 years of age born to diabetic as compared to non-diabetic mothers.Methods: This study was a retrospective cohort conducted in 2016 at The Aga Khan University Hospital, Karachi, Pakistan. It included children between 2 and 5 years of age born to mothers with and without exposure to diabetes in utero (n = 68 in each group) and who were appropriate for gestational age. Myocardial morphology and function using echocardiogram and carotid intima media thickness (cIMT) and pulse wave velocity was performed to evaluate cardiac function as well as macrovascular remodelling in these children. Multiple linear regression was used to compare the groups.Results: There was no significant difference in cardiac morphology, myocardial systolic and diastolic function, and macrovascular assessment between the exposed and unexposed groups of AGA children. Subgroup analysis demonstrated a significantly decreased mitral E/A ratio in children whose mothers were on medications as compared to those on dietary control (median [IQR] = 1.7 [1.6-1.9] and 1.56 [1.4-1.7], respectively, p = 0.02), and a higher cIMT in children whose mothers were on medication as compared to controls (0.48 [0.44-0.52] and 0.46 [0.44-0.50], respectively, p = 0.03).Conclusion: In utero exposure to uncontrolled maternal diabetes has an effect on the cardiovascular structure and function in children aged 2-5 years. However, future work requires long-term follow-up from fetal to adult life to assess these changes over the life course.
KW - Hyperglycaemia in pregnancy
KW - cardiovascular disease
KW - preschool children
KW - risk assessment
UR - http://www.scopus.com/inward/record.url?scp=85063939942&partnerID=8YFLogxK
U2 - 10.1017/S1047951119000040
DO - 10.1017/S1047951119000040
M3 - Article
C2 - 30940265
AN - SCOPUS:85063939942
SN - 1047-9511
VL - 29
SP - 467
EP - 474
JO - Cardiology in the Young
JF - Cardiology in the Young
IS - 4
ER -