Diabetes before or during pregnancy linked to early heart disease in children

If a mother has diabetes before becoming pregnant or during her pregnancy, her offspring risk being affected by heart diseases higher than children of mothers without diabetes. This is the conclusion of a study from AU and AUH which has just been published in the scientific journal BMJ.

”The risk of cardiovascular disease was increased in each age group in childhood before the age of twenty also and in early adulthood between the ages of twenty and forty, regardless of whether the children were ‘exposed’ to pregestational diabetes (type 1 or type 2 diabetes), or gestational diabetes,” explains Yong Fu, who has carried out the study together with Jiong Li.

The risk was particularly pronounced among the children of mothers who currently or previously had cardiovascular disease or complications in connection with their diabetes.

Early onset

The findings are based on data from more than 2.4 million children without congenital heart disease who were born in Denmark between 1977 and 2016. During the course of up to forty years of follow-up, the children of mothers with diabetes had a 29 per cent higher risk of an early 'onset' of cardiovascular disease compared to the children of mothers who had not had diabetes.

The number of women with diabetes before or during pregnancy has risen globally, and the children of these women are thus more likely to be in the risk group for cardiovascular diseases such as high blood pressure and high blood sugar levels.
 
“The findings underline the importance of effective strategies for screening and preventing diabetes in women of childbearing age – not only to improve the health of these women but also to reduce the long-term risk of cardiovascular diseases among their children," says Jiong Li.

The researchers categorised diabetes as before or during pregnancy, while at the same time identifying those women who had complications in connection with their diabetes. Other important factors such as age, education, and lifestyle (smoking during pregnancy) were also taken into account.
   
Jiong Li mentions that the study, which is a population-based cohort study, may not establish a direct causal relationship.

"We can’t rule out the possibility that some of the findings may be attributed to other unmeasured factors. However, the study’s strength is the extensive data material, the long follow-up period of up to forty years, and the fact that we arrived at the same results after further consideration of un-observed genetic or familial factors” explains Jiong Li.

Background for the results:

• The study is a population-based cohort study with a forty year follow-up.
• Partners: Henrik Toft Sørensen and Jørn Olsen from Aarhus University, Aarhus University Hospital, Onyebuchi A. Arah from UCLA Fielding School of Public Health, Zeyan Liew from Yale School of Public Health, Sven Cnattingius from Karolinska University Hospital, Karolinska Institute,  Guoyou Qin from Fudan University School of Public Health.
• Funding: The Lundbeck Foundation, The Independent Research Fund Denmark, The Nordic Cancer Union, Karen Elise Jensens Foundation, The Novo Nordisk Foundation, The National Natural Science Foundation of China, a NIH grant from The National Center for Advancing Translational Sciences, and The Eunice Kennedy Shriver National Institute of Child Health and Human Development.
• Read the article in BMJ   

Contact

PhD, MSc, Postdoc Yongfu Yu
Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University and
Aarhus University Hospital
Mobile: (+45) 7131 6566
yoyu@clin.au.dk

PhD, Associate Professor Jiong Li
Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University and
Aarhus University Hospital
Tel: (+45) 8716 8401
jl@clin.au.dk