Elevated maternal blood glucose associated with congenital heart disease in offspring
NEW ORLEANS — In mothers without diabetes, elevated blood glucose measured early in pregnancy was a predictor of congenital heart disease in offspring, according to data presented at the American Heart Association Scientific Sessions.
“Our study shows that elevated, early pregnancy glucose values in nondiabetic mothers are a risk for congenital heart disease in the offspring,” Emmi Helle, MD, PhD, MSc (Econ.), a postdoctoral research fellow in cardiovascular medicine at Stanford University, said in an interview. “Furthermore, first trimester glucose values are more strongly correlated with risk than an abnormal glucose tolerance test, which is currently used to risk stratify patients for echocardiographic screening.
In a retrospective, case-control study, Helle and colleagues analyzed data from 19,107 pregnant women from the Stanford Healthcare and Geisinger Health System, comparing live-born infants with congenital heart disease to infants without CHD. Researchers used logistic regression analysis to assess the relationship between maternal blood glucose measured between 4 weeks prior to conception and 15 weeks’ gestation, results of a 1-hour oral glucose tolerance test and risk for CHD in offspring.
After adjusting for maternal age, pregestational diabetes and prepregnancy BMI, researchers found that mothers who delivered infants with CHD had higher plasma glucose levels in early pregnancy vs. women who delivered infants without CHD (OR = 1.08; 95% CI, 1.02-1.13). Results of an OGTT did not reach statistical significance between groups, according to researchers (OR = 1.69; 95% CI, 0.9-2.91).
“For the first time, we show random, first trimester plasma glucose measured during early pregnancy is associated with risk for CHD in offspring, and furthermore, are more strongly correlated with risk than [an] abnormal OGTT,” the researchers wrote. “Though these conclusions are limited by the sampling bias inherent in retrospective studies, they support prospective investigation of first trimester glucose metabolites in the risk for CHD.”
Helle said she plans to conduct similar research using Finnish population-based health care registers and nationally collected early pregnancy serum samples, to examine the association in a larger and unbiased population. – by Regina Schaffer
Helle E, et al. Presentation 661. Presented at: American Heart Association Scientific Sessions; Nov. 12-16, 2016; New Orleans.
Disclosure: Helle reports no relevant financial disclosures.