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Pregnant Women With Elevated Blood Sugars Are At Greater Risk of Having Children With Heart Defects

Higher glucose levels associated with odds of tetralogy of Fallot and serum glucose.

Women with diabetes have already been found to have a high chance of having children with congenital heart disease. However, according to new study, which is published in JAMA Pediatrics, pregnant women with elevated blood-sugar levels also have a high risk of having children with congenital heart disease, even if they did not meet the diagnostic criteria for diabetes. In pregnancy, blood glucose production increases in the mother, ensuring that the fetus gets enough nourishment.

There are more studies focusing on gestational diabetes, but not many studies to investigate the link between fetal heart defects and women without a diabetes diagnosis.

The case-control study was conducted over four years in California. This study was a population-based cohort of 277 pregnant women who were carrying infants with tetralogy of Fallot (TOF), dextrotransposition of the great arteries (dTGA), or healthy infants without CHD. Random blood samples were collected during the second-trimester of pregnancy, and participants were not required to fast before the sample collection. The women’s levels of glucose and insulin were measured in the study. Multivariable logic regression models were used to test the association between those levels and the odds of having a baby with heart defect.

The result was only women who had fetuses with tetralogy of Fallot had higher average blood glucose levels, compared with women in the control group. At the same time, the study found women carrying fetuses with dextrotransposition of the great arteries had elevated insulin levels.

In conclusion, higher glucose levels are associated with the odds of tetralogy of Fallot and serum glucose, while there is no significant finding in the relationship between insulin levels and heart defect.

Insulin signaling and glucose metabolism are important physiologic processes in the mother. Therefore more and more studies should be encouraged to discover the link between the elevated glucose levels and birth defects.

Practice Pearls:

  • A case-control study focused on pregnant women with elevated glucose levels who are likely carrying babies with heart defect.
  • Higher glucose levels are associated with the odds of tetralogy of Fallot and serum glucose.
  • Researchers call for future research to evaluate the link between the elevated glucose levels and birth defects.

Gary M. Shaw et al. “Maternal Midpregnancy Glucose Levels and Risk of Congenital Heart Disease in Offspring.” http://archpedi.jamanetwork.com/article.aspx?articleid=2448716. JAMA Pediatrics, October 2015.