Relationship Between Gestational Diabetes and Cardiovascular Outcomes in the Offspring: A Systematic Review.
DOI:
10.52832/jesh.v5i3.550Keywords:
Gestational Diabetes Mellitus, Circulatory System Diseases, Prenatal Exposure Delayed Effects, Cardiometabolic Risk FactorsAbstract
Abstract: To investigate the association between prenatal exposure to gestational diabetes mellitus (GDM) and the development of cardiovascular diseases and cardiometabolic risk factors, from childhood to adulthood. Systematic review carried out between October and December 2024 in the Pubmed, Scielo, BVS and Cochrane databases. The descriptors “Cardiovascular disease”, “Diabetes, Gestational” and “Prenatal Exposure Delayed Effects” were combined by the AND operator. Following PRISMA guidelines, clinical trials and observational studies published between 2014 and 2024 were included, without language restrictions. The selection was conducted by two independent reviewers and disagreements resolved by a third reviewer. Of 63 articles identified, 43 were excluded by titles and abstracts. 20 continued for full reading. 09 were included after analysis according to ACROBAT-NRSI. A total of 1,107,252 participants (113,888 exposed vs. 993,364 control) were included, covering different follow-up periods. In the exposed group, a higher prevalence of obesity, hypertension, and insulin resistance was observed. Early changes such as atherogenic lipid profiles, increased carotid thickness, and structural changes in the left ventricle were observed, attributed to intrauterine hyperglycemia and intensified by epigenetic factors. GDM is associated with significant impacts on the cardiovascular and metabolic health of offspring, with early onset of risk factors, highlighting the importance of preventive interventions during pregnancy.
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Agarwal, P., Morriseau, T. S., Kereliuk, S. M., Doucette, C. A., Wicklow, B. A., & Dolinsky, V. W. (2018). Maternal obesity, diabetes during pregnancy and epigenetic mechanisms that influence the developmental origins of cardiometabolic disease in the offspring. Critical Reviews in Clinical Laboratory Sciences, 55(2), 71–101. https://doi.org/10.1080/10408363.2017.1422109
Alejandro, E. U., Mamerto, T. P., Chung, G., Villavieja, A., Gaus, N. L., Morgan, E., & Pineda-Cortel, M. R. B. (2020). Gestational Diabetes Mellitus: A Harbinger of the Vicious Cycle of Diabetes. International Journal of Molecular Sciences, 21(14), 5003. https://doi.org/10.3390/ijms21145003
Aris, I. M., Rifas-Shiman, S. L., Li, L., Belfort, M. B., Marie-France Hivert, & Oken, E. (2019). Early-Life Predictors of Systolic Blood Pressure Trajectories From Infancy to Adolescence: Findings From Project Viva. American Journal of Epidemiology, 188(11), 1913–1922. https://doi.org/10.1093/aje/kwz181
Aris, I. M., Soh, S. E., Mya Thway Tint, Saw, S.-M., Victor Samuel Rajadurai, Godfrey, K. M., Gluckman, P. D., Yap, F., Yap Seng Chong, & Yung Seng Lee. (2015). Associations of gestational glycemia and prepregnancy adiposity with offspring growth and adiposity in an Asian population ,. 102(5), 1104–1112. https://doi.org/10.3945/ajcn.115.117614
Battin, M. R., Obolonkin, V., Rush, E., Hague, W., Coat, S., & Rowan, J. (2015). Blood pressure measurement at two years in offspring of women randomized to a trial of metformin for GDM: follow up data from the MiG trial. BMC Pediatrics, 15(1). https://doi.org/10.1186/s12887-015-0372-1
Chen, Y., Huang, D., Liu, J., Zeng, F., Tang, G., Lei, W., Wang, H., Jiang, Y., Weihui Shentu, & Wang, H. (2021). Non-Invasive Detection of Fetal Vascular Endothelial Function in Gestational Diabetes Mellitus. Frontiers in Endocrinology, 12. https://doi.org/10.3389/fendo.2021.763683
Dessì, A., Bosco, A., Cesare Marincola, F., Pintus, R., Paci, G., Atzori, L., Fanos, V., & Piras, C. (2023). Sardinian Infants of Diabetic Mothers: A Metabolomics Observational Study. International Journal of Molecular Sciences, 24(18), 13724. https://doi.org/10.3390/ijms241813724
Freja Bach Kampmann, Cathrine, A., Hjort, L., Olsen, S. F., Sara Monteiro Pires, Tetens, I., & Louise Groth Grunnet. (2018). Exposure to Gestational Diabetes Is a Stronger Predictor of Dysmetabolic Traits in Children Than Size at Birth. The Journal of Clinical Endocrinology and Metabolism, 104(5), 1766–1776. https://doi.org/10.1210/jc.2018-02044
Furse, S., Koulman, A., Ozanne, S. E., Poston, L., White, S. J., & Meek, C. L. (2022). Altered Lipid Metabolism in Obese Women With Gestational Diabetes and Associations With Offspring Adiposity. 107(7), e2825–e2832. https://doi.org/10.1210/clinem/dgac206
Guillemette, L., Wicklow, B., Sellers, E. A. C., Dart, A., Shen, G. X., Dolinsky, V. W., Gordon, J. W., Jassal, D. S., Nickel, N., Duhamel, T. A., Chateau, D., Prior, H. J., & McGavock, J. (2020). Intrauterine exposure to diabetes and risk of cardiovascular disease in adolescence and early adulthood: a population-based birth cohort study. Canadian Medical Association Journal, 192(39), E1104–E1113. https://doi.org/10.1503/cmaj.190797
Horsch, A., Gilbert, L., Lanzi, S., Gross, J., Kayser, B., Vial, Y., Simeoni, U., Hans, D., Berney, A., Scholz, U., Barakat, R., Puder, J. J., & MySweetHeart Research Group. (2018). Improving cardiometabolic and mental health in women with gestational diabetes mellitus and their offspring: study protocol for MySweetHeart Trial, a randomised controlled trial. BMJ Open, 8(2), e020462. https://doi.org/10.1136/bmjopen-2017-020462
Julian P.T. Higgins, Morgan, R. L., Rooney, A. A., Taylor, K. W., Thayer, K. A., Silva, R. A., Lemeris, C., Akl, E. A., Bateson, T. F., Berkman, N. D., Glenn, B. S., Asbjørn Hróbjartsson, LaKind, J. S., McAleenan, A., Meerpohl, J. J., Nachman, R. M., Obbagy, J. E., O’Connor, A., Radke, E. G., & Jelena Savović. (2024). A tool to assess risk of bias in non-randomized follow-up studies of exposure effects (ROBINS-E). Environment International, 186, 108602–108602. https://doi.org/10.1016/j.envint.2024.108602
Kaseva, N., Vääräsmäki, M., Sundvall, J., Matinolli, H.-M., Sipola, M., Tikanmäki, M., Heinonen, K., Lano, A., Wehkalampi, K., Wolke, D., Ruokonen, A., Andersson, S., Järvelin, M.-R., Räikkönen, K., Eriksson, J. G., & Kajantie, E. (2019). Gestational Diabetes But Not Prepregnancy Overweight Predicts for Cardiometabolic Markers in Offspring Twenty Years Later. The Journal of Clinical Endocrinology and Metabolism, 104(7), 2785–2795. https://doi.org/10.1210/jc.2018-02743
Kereliuk, S. M., & Dolinsky, V. W. (2022). Recent Experimental Studies of Maternal Obesity, Diabetes during Pregnancy and the Developmental Origins of Cardiovascular Disease. International Journal of Molecular Sciences, 23(8), 4467. https://doi.org/10.3390/ijms23084467
Kizirian, N. V., Kong, Y., Muirhead, R., Brodie, S., Garnett, S. P., Petocz, P., Sim, K. A., Celermajer, D. S., Louie, J. C., Markovic, T. P., Ross, G. P., Ward, L. C., Brand-Miller, J. C., & Skilton, M. R. (2016). Effects of a low–glycemic index diet during pregnancy on offspring growth, body composition, and vascular health: a pilot randomized controlled trial. The American Journal of Clinical Nutrition, 103(4), 1073–1082. https://doi.org/10.3945/ajcn.115.123695
Krishnaveni, G. V., Veena, S. R., Jones, A., Srinivasan, K., Osmond, C., Karat, S. C., Kurpad, A. V., & Fall, C. H. D. (2015). Exposure to Maternal Gestational Diabetes Is Associated With Higher Cardiovascular Responses to Stress in Adolescent Indians. The Journal of Clinical Endocrinology & Metabolism, 100(3), 986–993. https://doi.org/10.1210/jc.2014-3239
Landon, M. B., Rice, M. M., Varner, M. W., Casey, B. M., Reddy, U. M., Wapner, R. J., Rouse, D. J., Biggio, J. R., Thorp, J. M., Chien, E. K., Saade, G., Peaceman, A. M., Blackwell, S. C., & VanDorsten, J. P. (2014). Mild Gestational Diabetes Mellitus and Long-Term Child Health. Diabetes Care, 38(3), 445–452. https://doi.org/10.2337/dc14-2159
Leybovitz-Haleluya, N., Wainstock, T., Landau, D., & Sheiner, E. (2018). Maternal gestational diabetes mellitus and the risk of subsequent pediatric cardiovascular diseases of the offspring: a population-based cohort study with up to 18 years of follow up. Acta Diabetologica, 55(10), 1037–1042. https://doi.org/10.1007/s00592-018-1176-1
Li, S., Wang, L., Yang, H., & Fan, L. (2024). Changes in the shape and function of the fetal heart of pre- and gestational diabetes mothers. BMC Pregnancy and Childbirth, 24(1). https://doi.org/10.1186/s12884-024-06262-z
Lowe, W. L., Scholtens, D. M., Kuang, A., Linder, B., Lawrence, J. M., Lebenthal, Y., McCance, D., Hamilton, J., Nodzenski, M., Talbot, O., Brickman, W. J., Clayton, P., Ma, R. C., Tam, W. H., Dyer, A. R., Catalano, P. M., Lowe, L. P., & Metzger, B. E. (2019). Hyperglycemia and Adverse Pregnancy Outcome Follow-up Study (HAPO FUS): Maternal Gestational Diabetes Mellitus and Childhood Glucose Metabolism. Diabetes Care, 42(3), 372–380. https://doi.org/10.2337/dc18-1646
Lu, J., Zhang, S., Li, W., Leng, J., Wang, L., Liu, H., Li, W., Zhang, C., Qi, L., Tuomilehto, J., Chen, J., Yang, X., Yu, Z., & Hu, G. (2019). Maternal Gestational Diabetes Is Associated With Offspring’s Hypertension. American Journal of Hypertension, 32(4), 335–342. https://doi.org/10.1093/ajh/hpz005
Luo, L., Zhang, S., Wang, T., Diao, J., Li, J., Li, Y., Zhao, L., Chen, L., Ye, Z., Huang, P., & Qin, J. (2021). Associations of maternal diabetes mellitus and adiponectin gene polymorphisms with congenital heart disease in offspring: A case-control study. Medicine (Baltimore), e24672–e24672. https://pesquisa.bvsalud.org/portal/resource/pt/mdl-33655931
McGuinness, L. A., & Higgins, J. P. T. (2020). Risk‐of‐bias VISualization (robvis): An R package and Shiny web app for visualizing risk‐of‐bias assessments. Research Synthesis Methods, 12(1). https://doi.org/10.1002/jrsm.1411
Nunes, J. S., Ladeiras, R., Machado, L., Coelho, D., Duarte, C., & Furtado, J. M. (2020). The Influence of Preeclampsia, Advanced Maternal Age and Maternal Obesity in Neonatal Outcomes Among Women with Gestational Diabetes. Revista Brasileira de Ginecologia E Obstetrícia / RBGO Gynecology and Obstetrics, 42(10), 607–613. https://doi.org/10.1055/s-0040-1710300
Oviedo, C. P., & Viteri, J. S. (2015). Pregunta de investigación y estrategia PICOT. Medicina, 19(1), 66–69. https://dialnet.unirioja.es/servlet/articulo?codigo=5584874
Sabolović Rudman, S. (2019). Pregnancy Outcome in Gestational Diabetes Compared to Body Mass Index. Acta Clinica Croatica. https://doi.org/10.20471/acc.2019.58.01.05
Silvia Sánchez Serrano, Inmaculada Pedraza Navarro, & Macarena Donoso González. (2022). ¿Cómo hacer una revisión sistemática siguiendo el protocolo PRISMA?: Usos y estrategias fundamentales para su aplicación en el ámbito educativo a través de un caso práctico. Bordón: Revista de Pedagogía, 74(3), 51–66. https://dialnet.unirioja.es/descarga/articulo/8583045.pdf
Smith, A., Franklin, O., McCallion, N., Breathnach, F., & El-Khuffash, A. (2023). Assessment of Myocardial Function in Infants of Mothers with Gestational Diabetes Mellitus Using Deformation Imaging over the First Year of Age. The Journal of Pediatrics, 263, 113645. https://doi.org/10.1016/j.jpeds.2023.113645
Smith, A., Franklin, O., McCallion, N., Breatnach, F., & EL-Khuffash, A. (2021). Effect of Gestational Diabetes Mellitus on Neonatal Myocardial Function. Neonatology, 118(1), 64–72. https://doi.org/10.1159/000513041
Stefano Di Bernardo, Yvan Mivelaz, Adina Mihaela Epure, Vial, Y., Simeoni, U., Pascal Bovet, Sandrine Estoppey Younes, Arnaud Chiolero, & Sekarski, N. (2017). Assessing the consequences of gestational diabetes mellitus on offspring’s cardiovascular health: MySweetHeart Cohort study protocol, Switzerland. 7(11), e016972–e016972. https://doi.org/10.1136/bmjopen-2017-016972
Tam, W. H., Ma, R. C. W., Ozaki, R., Li, A. M., Chan, M. H. M., Yuen, L. Y., Lao, T. T. H., Yang, X., Ho, C. S.,
Tutino, G. E., & Chan, J. C. N. (2017). In Utero Exposure to Maternal Hyperglycemia Increases Childhood Cardiometabolic Risk in Offspring. Diabetes Care, 40(5), 679–686. https://doi.org/10.2337/dc16-2397
Yuan, W. L., Lin, J., Kramer, M. S., Godfrey, K. M., Gluckman, P. D., Chong, Y.-S., Shek, L. P., Tan, K. H., Chan, S.-Y., Eriksson, J. G., Yap, F., Lee, Y. S., Jonathan, & Ling, L. H. (2020). Maternal Glycemia During Pregnancy and Child Carotid Intima Media Thickness, Pulse Wave Velocity, and Augmentation Index. J Clin Endocrinol Metab. https://pesquisa.bvsalud.org/portal/resource/pt/mdl-32315399
Zahra Hoodbhoy, Mohammed, N., Aslam, N., Fatima, U., Salima Ashiqali, Rizvi, A., Pascua, C., Chowdhury, D., & Hasan, B. S. (2019). Is the child at risk? Cardiovascular remodelling in children born to diabetic mothers.
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