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- Title
Intrauterine exposure to diabetes and risk of cardiovascular disease in adolescence and early adulthood: a population-based birth cohort study.
- Authors
Guillemette, Laetitia; Wicklow, Brandy; Sellers, Elizabeth A.C.; Dart, Allison; Shen, Garry X.; Dolinsky, Vernon W.; Gordon, Joseph W.; Jassal, Davinder S.; Nickel, Nathan; Duhamel, Todd A.; Chateau, Dan; Prior, Heather J.; McGavock, Jonathan
- Abstract
<bold>Background: </bold>It is unclear whether intrauterine exposure to maternal diabetes is associated with risk factors for cardiovascular disease and related end points in adulthood. We examined this potential association in a population-based birth cohort followed up to age 35 years.<bold>Methods: </bold>We performed a cohort study of offspring born between 1979 and 2005 (n = 293 546) and followed until March 2015 in Manitoba, Canada, using registry-based administrative data. The primary exposures were intrauterine exposure to gestational diabetes and type 2 diabetes mellitus. The primary outcome was a composite measure of incident cardiovascular disease events, and the secondary outcome was a composite of risk factors for cardiovascular disease in offspring followed up to age 35 years.<bold>Results: </bold>The cohort provided 3 628 576 person-years of data (mean age at latest follow-up 20.5 [standard deviation 6.4] years, 49.3% female); 2765 (0.9%) of the offspring experienced a cardiovascular disease end point, and 12 673 (4.3%) experienced a cardiovascular disease risk factor. After propensity score matching, the hazard for cardiovascular disease end points was elevated in offspring exposed to gestational diabetes (adjusted hazard ratio [HR] 1.42, 95% confidence interval [CI] 1.12-1.79) but not type 2 diabetes (adjusted HR 1.40, 95% CI 0.98-2.01). A similar association was observed for cardiovascular disease risk factors (gestational diabetes: adjusted HR 1.92, 95% CI 1.75-2.11; type 2 diabetes: adjusted HR 3.40, 95% CI 3.00-3.85).<bold>Interpretation: </bold>Intrauterine exposure to maternal diabetes was associated with higher morbidity and risk related to cardiovascular disease among offspring up to 35 years of age.
- Subjects
MANITOBA; CARDIOVASCULAR diseases risk factors; GESTATIONAL diabetes; TYPE 2 diabetes; CARDIOVASCULAR diseases; DISEASE risk factors; COHORT analysis; ACQUISITION of data; PRENATAL exposure delayed effects; LONGITUDINAL method
- Publication
Canadian Medical Association Journal (CMAJ), 2020, Vol 192, Issue 39, pE1104
- Publication type
journal article
- DOI
10.1503/cmaj.190797