Effect of gestational diabetes and insulin resistance on offspring's myocardial relaxation kinetics at three years of age

PLoS One. 2018 Nov 21;13(11):e0207632. doi: 10.1371/journal.pone.0207632. eCollection 2018.

Abstract

Purpose: Scientific evidence on the long-term impact of gestational diabetes mellitus (GDM) on offspring's myocardial relaxation is scarce. Studies have linked GDM with transient ventricular hypertrophy in newborns resulting in diastolic dysfunction, but long-term assessment is lacking. The main objective of this study was to evaluate myocardial relaxation in 3-year-old children in relation to the degree of insulin resistance of their mother during pregnancy.

Methods: We prospectively assessed myocardial relaxation by echocardiography imaging on 106 children at 3 years of age. Subjects were divided into 3 groups [GDM, insulin resistance (IR) and normoglycemic (CTRL)], based on their mother's 75g-OGTT and HOMA-IR results at second trimester screening. We collected information on children adiposity and body size, maternal characteristics and maternal and cord blood measurement of C-peptide and insulin.

Results: The study population comprised 29 children from GDM mothers, 36 children from IR mothers and 41 CTRL children. Compared to the CTRL group, we found that a higher proportion of children in the IR group and the GDM group met the criteria for impaired myocardial relaxation, but this did not reach statistical significance (odds ratio adjusted for heart rate and body surface area of 1.4 [0.2-9.5] and 3.5 [0.6-20.6], respectively).

Conclusion: We did not detect an increased risk of impaired myocardial relaxation at three years of age in children exposed in-utero to IR and GDM, compared to children from normoglycemic mothers.

MeSH terms

  • Body Mass Index
  • Body Size
  • Cardiomegaly / diagnostic imaging*
  • Cardiomegaly / etiology
  • Child, Preschool
  • Diabetes, Gestational / epidemiology*
  • Echocardiography
  • Female
  • Humans
  • Insulin Resistance*
  • Male
  • Odds Ratio
  • Pregnancy
  • Prenatal Exposure Delayed Effects / diagnostic imaging*
  • Prospective Studies

Grants and funding

The study was supported by the Centre de recherche du CHUS (programme d’aide de financement interne), by the Fonds de Recherche du Québec – Santé operating grant (FRQ-S #20697 recipient: MFH, URL: www.frqs.gouv.qc.ca), and by the Canadian Institute of Health Research (CIHR #MOP 115071, recipient: MFH, URL: www.cihr-irsc.gc.ca). LB and FD are junior research scholars from the FRQ-S and members of the FRQS-funded Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke. MFH is the recipient an ADA Pathways Accelerator Award (#1-15-ACE-2, URL: www.diabetes.org/pathway/program/grant-information.html). JP was supported by the FRQ-S, Diabète Québec (URL: www.diabete.qc.ca) and the Centre de recherche Mère-Enfant of Sherbrooke’s University. SB was supported by a CIHR master’s scholarship and a FRQ-S master’s scholarship.