Hyperglycaemia in pregnancy and cardio metabolic risk parameters in the offspring at 10-11 years

Abstract

INTRODUCTION & OBJECTIVES: Studies of developmental origins of health and disease have highlighted the possible role of hyperglycaemic intrauterine environment mediating and accelerating the current epidemic of diabetes and non-communicable diseases through foetal programming and epigenetic changes. While the perinatal and neonatal risks of hyperglycaemia in pregnancy (HIP) are well established, the long-term risks for the offspring are less explored. This study aimed to determine the association between HIP and cardiometabolic risk parameters in the offspring at 10-11 years. METHODS: A community based retrospective cohort study was conducted in the Colombo district. In the first stage, children born in 2005 were identified and the availability of antenatal records were assessed. In the second stage, exposure status of participants was ascertained based on antenatal records. In the third stage, eligible children were examined with blood pressure (BP), fasting blood sugar (FBS) and lipid profile to ascertain outcome status. RESULTS: 159 children of mothers with HIP (exposed) and 253 children of mothers with no HIP (non-exposed) participated. Mean ages (SD) of exposed and non-exposed groups were 10.9(0.3) and 10.8(0.3) years, respectively. Exposed children had a significantly higher risk of developing impaired fasting glycaemia (OR=5.6; 95% CI: 1.2-28.9), elevated total cholesterol (OR=2.1; 95% Cl: 1.3- 3.4), elevated low-density lipoprotein cholesterol (OR=1.9; 95% CI: 1.2-3.3) and elevated triglycerides (OR=2.5; 95% CI: 1.4-4.3). There was no significant difference in the BP and elevated high-density lipoprotein cholesterol between the exposed and non-exposed groups. CONCLUSION: Exposure to HIP increases the cardiometabolic risk in the offspring and these children need long-term follow up