Maternal Diabetes Mellitus as a Risk Factor for High Blood Pressure in Late Childhood

Author:

Miranda Joana Oliveira123,Cerqueira Rui João423,Barros Henrique56,Areias José Carlos17

Affiliation:

1. From the Departamento de Cardiologia Pediátrica (J.O.M., J.C.A.), Centro Hospitalar São João, Porto, Portugal

2. Departamento de Cirurgia e Fisiologia (J.O.M., R.J.C.), Faculdade de Medicina da Universidade do Porto, Portugal

3. Unidade de Investigação Cardiovascular (J.O.M., R.J.C.), Universidade do Porto, Portugal.

4. Departamento de Cirurgia Cardiotorácica (R.J.C.), Centro Hospitalar São João, Porto, Portugal

5. Departamento de Ciências da Saúde Pública e Forenses e Educação Médica (H.B.), Faculdade de Medicina da Universidade do Porto, Portugal

6. EPIUnit - Instituto de Saúde Pública (H.B.), Universidade do Porto, Portugal.

7. Departamento de Ginecologia-Obstetrícia e Pediatria (J.C.A.), Faculdade de Medicina da Universidade do Porto, Portugal

Abstract

Intrauterine fetal conditions can have lifelong cardiovascular effects. The impact of maternal diabetes mellitus on children’s cardiovascular profile is not well established. The goal of this study was to explore the association between maternal diabetes mellitus and offspring’s blood pressure (BP) ≤10 years of age. Generation XXI is a prospective birth cohort, which enrolled 8301 mother-offspring pairs, including 586 (7.1%) children of diabetic mothers. The associations between maternal diabetes mellitus and BP at 4, 7, and 10 years of age was modeled using linear regression. A mixed-effects model was built to assess differences in BP variation over time. Path analysis was used to quantify effects of potential mediators. Maternal diabetes mellitus was associated with higher BP in offspring at the age of 10 (systolic: β, 1.48; 95% CI, 0.36–2.59; and diastolic: β, 0.86; 95% CI, 0.05–1.71). This association was independent of maternal perinatal characteristics, and it was mediated by child’s body mass index and, to a lesser extent, by gestational age, type of birth, and birth weight (indirect effect proportion, 73%). No significant differences in BP were found at 4 and 7 years of age. Longitudinal analysis showed an accelerated systolic BP increase on maternal diabetes mellitus group (β, 1.16; 95% CI, 0.03–2.28). These finding were especially relevant in males, suggesting sex differences in the mechanisms of BP prenatal programing. Our results provide further evidence that maternal diabetes mellitus is associated with high BP late in childhood, demonstrating a significant role of child’s body mass in the pathway of this association.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Internal Medicine

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