Abstract
Objective
Gestational diabetes mellitus (GDM) and delivery of a small for gestational age (SGA) neonate have both been associated with long-term maternal cardiovascular morbidity. We sought to assess whether delivery of an SGA neonate to mother with GDM increases the risk of long-term cardiovascular morbidity in the offspring as compared with SGA to mothers without GDM.
Study Design
This is a population-based retrospective cohort study. The primary exposure was defined as delivery of an SGA infant to mother with GDM. Delivery of an SGA infant to mother without GDM comprised the comparison group. The main outcome evaluated was cardiovascular morbidity of the offspring up to the age of 18 years, predefined in a set of ICD 9 codes as documented in any hospitalization record. Kaplan-Meier survival curve was used to estimate cumulative incidence of cardiovascular hospitalizations. A Cox proportional hazards model was used to estimate the adjusted hazard ratios (HR) for cardiovascular morbidity.
Results
During the study period, 9,312 SGA newborns met the inclusion criteria, of which 2.7% (n= 259) were born to diabetic mothers. SGA children born to mothers with GDM had significantly higher rates of cardiovascular related morbidity (1.9% vs 0.7%, p=0.026; Table). A Kaplan Meier survival curve demonstrated that SGA children born to GDM mothers had higher cumulative incidence of cardiovascular morbidity (log-rank test p=0.037; Figure). In the Cox regression model, while controlling for confounders such as gestational age, parity, ethnicity and hypertensive disorders, delivery of an SGA neonate to mother with GDM was found to be independently associated with long-term cardiovascular morbidity of the offspring (adjusted HR=2.6; 95% CI 1.02-6.55 P=0.045).
Conclusion
Delivery of an SGA neonate to mother with GDM is independently associated with long-term cardiovascular morbidity of the offspring.
Gestational diabetes mellitus (GDM) and delivery of a small for gestational age (SGA) neonate have both been associated with long-term maternal cardiovascular morbidity. We sought to assess whether delivery of an SGA neonate to mother with GDM increases the risk of long-term cardiovascular morbidity in the offspring as compared with SGA to mothers without GDM.
Study Design
This is a population-based retrospective cohort study. The primary exposure was defined as delivery of an SGA infant to mother with GDM. Delivery of an SGA infant to mother without GDM comprised the comparison group. The main outcome evaluated was cardiovascular morbidity of the offspring up to the age of 18 years, predefined in a set of ICD 9 codes as documented in any hospitalization record. Kaplan-Meier survival curve was used to estimate cumulative incidence of cardiovascular hospitalizations. A Cox proportional hazards model was used to estimate the adjusted hazard ratios (HR) for cardiovascular morbidity.
Results
During the study period, 9,312 SGA newborns met the inclusion criteria, of which 2.7% (n= 259) were born to diabetic mothers. SGA children born to mothers with GDM had significantly higher rates of cardiovascular related morbidity (1.9% vs 0.7%, p=0.026; Table). A Kaplan Meier survival curve demonstrated that SGA children born to GDM mothers had higher cumulative incidence of cardiovascular morbidity (log-rank test p=0.037; Figure). In the Cox regression model, while controlling for confounders such as gestational age, parity, ethnicity and hypertensive disorders, delivery of an SGA neonate to mother with GDM was found to be independently associated with long-term cardiovascular morbidity of the offspring (adjusted HR=2.6; 95% CI 1.02-6.55 P=0.045).
Conclusion
Delivery of an SGA neonate to mother with GDM is independently associated with long-term cardiovascular morbidity of the offspring.
| Original language | English |
|---|---|
| Pages (from-to) | S573-S573 |
| Journal | American Journal of Obstetrics and Gynecology |
| Volume | 218 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 2018 |
