Maternal diabetes increases children's risk for congenital heart defects

Hello, and associates gathered data from the national registry of all Finnish-born children born between 2006 and 2016 as well as their mothers. The Registry of Congenital Malformations provided information on children with isolated congenital cardiac abnormalities. Diabetes diagnosis and maternal BMI data were gathered from the Medical Birth Register.

The study comprised 573,259 mothers and 620,751 children who were between the ages of 20 and 40. 1.7% of the kids had a single, congenital cardiac condition. In 2006, 10.3% of moms had gestational diabetes; by 2016, that number had risen to 19.2%. In 2006 and 2016, the prevalence of type 2 diabetes was 0.1%, and in 2006 and 2016, the prevalence of type 1 diabetes was 0.6% and 0.7%, respectively. 8.2% of moms with a normal BMI, 21.1% of mothers who were overweight, and 41.1% of mothers who were obese had gestational diabetes.

In a multivariate regression analysis, the risks of congenital cardiac abnormalities were higher in offspring of mothers with type 1 diabetes (adjusted OR = 3.77; 95% CI, 3.26-4.36) or type 2 diabetes (a OR = 1.92; 95% CI, 1.34-2.75) than in offspring of mothers without diabetes.

According to recent studies, children born to moms with diabetes have an increased chance of congenital cardiac abnormalities. Preventive maternal health management is crucial because maternal diabetes increases the risk of certain cardiac abnormalities, especially if it is not adequately managed throughout pregnancy.

A structural anomaly in the heart or main blood arteries around the heart that exists from birth is known as a congenital heart defect (CHD). The heart's capacity to contract or function normally can be impacted by these problems, which can affect the valves, blood channels, or heart muscles itself. The severity of CHDs varies, ranging from mild abnormalities that might not need medical attention to serious illnesses that need to be treated right away. CHDs afflict about 1% of live births globally, making them one among the most common birth defects.

While the precise origin of CHDs is frequently unknown, potential causes include environmental factors, maternal health issues, genetic factors, or a mix of these. One important risk factor for CHDs has been found to be maternal diabetes, specifically gestational and pre-existing diabetes.

Type 1 diabetes mellitus (T1DM), formerly known as insulin dependent diabetes mellitus, Type 2 diabetes mellitus (T2DM), which is strongly linked to lifestyle factors like obesity, physical inactivity, and poor dietary habits, and gestational diabetes mellitus (GDM), which develops or is first diagnosed during pregnancy, are among the various types of diabetes mellitus.

Pregnancy-related hormonal changes and elevated insulin resistance are likely to be the cause. The fetus may be impacted by T2DM or GDM, which may raise the chance of congenital abnormalities such CHDs. Although GDM typically goes away after childbirth, it can have a number of side effects, such as jitteriness, hypoglycemia, neonatal jaundice, larger babies, which increase the risk of birth traumas, breathing difficulties due to surfactant degradation, and an increased risk of birth defects.

Thankfully, GDM is a modifiable risk factor for CHDs, meaning there is ample time to attempt and avoid potentially fatal anomalies from being discovered right after delivery.

There is sufficient data to conclude that GDM and CHDs are related. A few of the hypothesized underlying causes for the aforementioned risk include modification of embryonic cardiac gene expression, abnormal cardiac development brought on by maternal hyperglycemia, and oxidative stress and DNA damage caused by hyperglycemia. Congenital abnormalities can be more likely in people with GDM if they have additional risk factors such as obesity and hypertension.

All mothers with GDM should have antenatal screening, and fetal echocardiography should be performed to check for heart problems. This will lower the incidence and aid in early diagnosis. A similar improvement in overall outcomes can be obtained by early detection of GDM and optimal control of blood glucose, which can be accomplished through the collaborative efforts of obstetricians, endocrinologists, physicians, specialists in fetal medicine, and neonatologists.

In summary, congenital heart abnormalities (CHDs) are among the most prevalent birth defects and can provide serious challenges not only during the critical neonatal period but also in the long run. Although it is controllable, maternal diabetes—both type 2 and type 1—is a significant cause for concern when it comes to CHDs. Strict blood glucose control is crucial to lowering the risk of congenital abnormalities and improving outcomes for both mother and child. It should be practiced both before and during pregnancy, coupled with appropriate perinatal care.