The prevalence of cardiovascular disease (CVD) has increased in children and young adults in recent decades. A better understanding of the cause of the rise is essential to preventing and managing CVD among children and young adults. Previous studies have suggested the intergenerational links between maternal diabetes during or before pregnancy and risk factors for obesity, diabetes, chronic kidney disease and hypertensive disease among offspring. It is unclear, however, whether or to what extent prenatal exposure to maternal diabetes increases the risk of CVD in offspring over a lifetime.
To evaluate the associations between maternal diabetes and CVD in offspring, researchers from Fudan University, Aarhus University, UCLA, Yale University and Karolinska Institute conducted a Danish population based cohort study, including 2,432,000 liveborn children without congenital heart disease in Denmark during 1977-2016 using the Danish national health registries. They examined the associations between intrauterine exposure to maternal diabetes and excess risk of early-onset CVD in offspring and looked into the combined effect of maternal diabetes and maternal history of CVD on these associations.
Their research was published in British Medical Journal under the title“Maternal diabetes during pregnancy and early onset of cardiovascular disease in offspring: population based cohort study with 40 years of follow-up” (IF=27.604) on December 5.
It’s been found that offspring of mothers with diabetes had a 29% increased overall rate of early-onset CVD and that pregestational diabetes, including type 1 and type 2 diabetes, and gestational diabetes increased rates of early-onset CVD in offspring. Besides, the early onset CVD risk may be 60%-73% higher for the offspring of mothers with CVD or maternal diabetic compications. Varied increased rates of specific early-onset CVDs, particularly heart failure, hypertensive disease, deep vein thrombosis and pulmonary embolism, were also observed.
The research is the first of its kind to use big data to confirm that children of mothers with diabetes, especially those with a history of CVD or diabetic complications, have increased rates of early-onset CVD from childhood to early adulthood up to 40 years of age. If maternal diabetes does have a causal association with increased CVD rate in offspring, the prevention, screening, and treatment of diabetes in women of childbearing age could help to reduce the risk of CVD in the next generation.
Dr. Yu Yongfu from Aarhus University and UCLA is the first author of this study, with Prof. Qin Guoyou from FDU School of Public Health and Prof. Jiong Li from Aarhus University being the corresponding authors and senior authors
Full text link: https://www.bmj.com/content/367/bmj.l6398
