By Lisa Rapaport

(Reuters Health) – People whose mothers had diabetes during pregnancy may be at increased risk of developing cardiovascular disease by early adulthood, a recent study suggests.

The analysis followed more than 2.4 million babies born in Denmark for up to four decades, including nearly 55,000 whose mothers had diabetes during pregnancy. During the study period, cardiovascular disease developed before age 40 in 1,153 people whose mothers had diabetes while pregnant and 91,311 whose mothers did not.

When mothers had diabetes during pregnancy, their offspring were 29% more likely to develop cardiovascular disease, researchers report in The BMJ.

“Preventing, screening and treating diabetes in women of childbearing age may be important not only for improving health of the women but also for reducing long-term cardiovascular disease risks in their offspring,” said study leader Yongfu Yu of Aarhus University in Denmark.

“We also need to monitor cardiovascular disease risks in offspring of diabetic mothers and investigate possible life-course interventions that may reduce the occurrence of cardiovascular disease,” Yu said by email.

A total of 26,272 infants were born to mothers who had gestational diabetes, which develops during pregnancy and usually disappears after the pregnancy is over.

Another 22,055 babies were exposed to their mother’s type 1 diabetes, which typically develops in childhood or young adulthood when the pancreas can’t produce insulin.

And 6,537 infants were exposed to maternal type 2 diabetes, which is linked to overweight and aging and happens when the body can’t properly use insulin to convert blood sugar into energy.

Gestational diabetes was associated with a 19% higher risk of cardiovascular disease in early adulthood for the children, while exposure to maternal type 1 or type 2 diabetes was tied to a 34% greater risk of cardiovascular disease for the young adult children.

The study wasn’t designed to determine whether maternal diabetes causes cardiovascular disease or hastens its development in offspring.

The children exposed in utero to maternal diabetes were also more likely to have parents with a history of cardiovascular disease, and to have higher rates as adults of obesity, high blood pressure, high cholesterol, chronic kidney disease – and diabetes, which is itself a powerful risk factor for heart disease.

Yu noted that pregnant women with diabetes have more glucose, or sugars, in the placenta, which may lead developing babies to produce more insulin and have higher levels of blood sugar while they’re in the womb. That, in turn, could potentially lead to changes in blood vessel function later in life that contribute to cardiovascular disease.

“We have known for a while that children born to women with diabetes, including both diabetes before pregnancy as well as gestational diabetes, have a higher rate of important complications early in life including macrosomia (babies that are too large sometimes resulting in difficult deliveries), a higher rate of congenital malformations, more frequent admission to NICU because of babies having difficulties regulating their own blood sugar levels, to name a few,” said Dr. Jorge Chavarro of the Harvard T.H. Chan School of Public Health in Boston.

These babies are known to have higher risks for being overweight or obese in childhood, and recent work has also suggested they’re at higher risk of cardiovascular and metabolic diseases as adults based on risk factors like levels of sugar and fats in the blood, said Chavarro, who wasn’t involved in the study. This new study, he said by email, “provides evidence that maternal diabetes can also result in a higher frequency of clinically relevant cardiovascular events during the first four decades of life.”

SOURCE: The BMJ, online December 4, 2019.