OBJECTIVE Prenatal exposure to maternal diabetes is associated with an increased risk of offspring heart defects. We evaluated associations with subtle infant cardiac changes. RESEARCH DESIGN AND METHODS In a cohort of 25,486 infants with transthoracic echocardiography within 60 days of birth, we investigated associations between maternal preexisting diabetes and gestational diabetes mellitus (GDM) and infant left ventricular (LV) structural and functional parameters, using linear regression to estimate adjusted mean differences (aMDs) between groups. RESULTS Infants exposed to maternal preexisting diabetes (n = 198) had thicker LV posterior walls (aMD 0.19 mm; 95% CI 0.11, 0.27), smaller LV internal diameters in systole (aMD −0.27 mm; 95% CI −0.45, −0.18) and diastole (aMD −0.37 mm; 95% CI −0.59, −0.09), reduced stroke volumes (aMD −0.36 mL; 95% CI −0.61, −0.11), and increased heart rates (aMD 3.14 bpm; 95% CI 1.10, 6.18) and mitral valve early peak velocities (aMD 2.17 cm/s; 95% CI 0.31, 4.04) than unexposed infants (n = 24,639). Infants born to mothers with GDM (n = 649) had significantly smaller LV internal diameters in systole (aMD −0.13 mm; 95% CI −0.22, −0.03) and similar structural and functional changes as children exposed to preexisting diabetes, albeit with smaller nonsignificant aMDs. Higher third-trimester HbA1c levels were associated with smaller LV internal diameters and stroke volumes in infants exposed to preexisting diabetes and with lower heart rates in infants exposed to GDM. CONCLUSIONS Maternal preexisting diabetes and, to a lesser extent, GDM were associated with changes in infant LV structure and function.

中文翻译：

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母体糖尿病与婴儿心脏左心室结构和功能：哥本哈根婴儿心脏研究


目的 产前暴露于母体糖尿病与后代心脏缺陷风险增加有关。我们评估了与婴儿细微心脏变化的关联。研究设计和方法 在出生后 60 天内接受经胸超声心动图检查的 25,486 名婴儿队列中，我们调查了母体先前存在的糖尿病与妊娠糖尿病 （GDM） 与婴儿左心室 （LV） 结构和功能参数之间的关联，使用线性回归估计调整后的平均差 （aMDs） 组间。结果 暴露于母体先前存在的糖尿病的婴儿 （n = 198） 左心室后壁较厚（aMD 0.19 mm;95% CI 0.11,0.27），收缩期 （aMD -0.27 mm;95% CI -0.45，-0.18） 和舒张期 （aMD -0.37 mm;95% CI -0.59，-0.09） 左心室内径较小，每搏输出量减少（aMD -0.36 mL;95% CI -0.61，-0.11）和心率增加（aMD 3.14 bpm;95% CI 1.10， 6.18） 和二尖瓣早期峰值速度 （aMD 2.17 cm/s;95% CI 0.31， 4.04） 与未暴露的婴儿 （n = 24,639） 相比。患有 GDM 的母亲 （n = 649） 所生婴儿的收缩期 LV 内径显著较小 （aMD -0.13 mm;95% CI -0.22， -0.03），并且与先前存在的糖尿病儿童具有相似的结构和功能变化，尽管 aMD 较小，但无显著性 aMD。妊娠晚期 HbA1c 水平较高与既往糖尿病婴儿的 LV 内径和每搏输出量较小相关，而 GDM 婴儿的心率较低。结论 母亲先前存在的糖尿病和较小程度的 GDM 与婴儿 LV 结构和功能的变化相关。