Abstract 17229: First Trimester Elevated Serum Glucose Values Are Associated With Congenital Heart Disease in the Offspring
Introduction: Maternal diabetes mellitus (DM) during pregnancy is a well known and prevalent risk factor for congenital heart disease (CHD) in offspring. In mothers without DM, we recently observed an association between elevated serum glucose values measured in the second trimester and the risk for CHDs in offspring.
Hypothesis: As cardiac development largely occurs during weeks 4-12 of gestation, we hypothesized that measurements of glucose metabolism during early pregnancy, i.e., well before the second trimester, would be associated with risk for CHD.
Methods: We performed a multi-institutional retrospective case-control study from a population-based cohort of 19,107 pregnant women from Stanford Healthcare and Geisinger Health System comparing liveborn infants with CHD to infants without CHD (Table 1). Multivariable logistic regression analysis was used to investigate the association between 1) mother’s plasma glucose values from 4 weeks prior to conception to 15 weeks and 2) the 1hour glucose tolerance test value (OGTT) and risk for CHD the offspring. The model was adjusted for known maternal risk factors for CHD (maternal age, pregestational DM, prepregnancy BMI).
Results: Early pregnancy plasma glucose values were significantly higher in mothers who delivered offspring with any CHD relative to mothers of infants without CHD (aOR 1.08; 95% CI 1.02-1.13; Table 2). The OGTT did not reach statistical significance between these groups (aOR 1.69; 95%CI 0.9-2.91).
Conclusions: For the first time we show random first trimester plasma glucose measured during early pregnancy is associated with risk for CHD in offspring, and furthermore are more strongly correlated with risk than abnormal OGTT (which is currently used to risk-stratify patients for echocardiographic screening). Though these conclusions are limited by the sampling bias inherent in retrospective studies, they support prospective investigation of first trimester glucose metabolites in the risk for CHD.
Author Disclosures: E. Helle: None. P.S. Biegley: None. J.W. Knowles: None. J.B. Leader: None. S.A. Pendergrass: None. G. Reaven: None. M.D. Ritchie: None. G.M. Shaw: None. W. Yang: None. J.R. Priest: None.
- © 2016 by American Heart Association, Inc.