Dear Editor,
Taye et al. aimed to identify determinants of gestational diabetes mellitus (GDM) among pregnant women in EthiopiaCitation1. They demonstrated that a family history of diabetes mellitus (odds ratio [OR] 1.837; 95% confidence interval [CI] 1.06–3.18), a history of spontaneous abortion (OR 2.39; 95% CI 1.33–4.31), a history of stillbirth (OR 2.240; 95% CI 1.222–4.105) and a history of delivery of a macrosomic baby in the previous pregnancy (OR 1.99; 95% CI 1.157–3.43) were predictors of GDMCitation1.
Due to the obesity pandemic, the prevalence of GDM has increased exponentially in the last few yearsCitation2–4. Maternal obesity not only makes GDM and pre-eclampsia during pregnancy more likely, but it also increases the risk of the mother developing metabolic syndrome and type 2 diabetes in later lifeCitation2–4. Besides the mother, GDM has implications for the fetus, including macrosomia, increased fetal cardiovascular disease and a high risk of metabolic and endocrine dysfunction in the offspring later in lifeCitation5,Citation6.
We have previously identified potential prognostic biomarkers of cardiovascular disease in large-for-gestational-age fetuses born to mothers with GDMCitation7. Serum cardiotrophin-1 (p < .001) and titin (p = .023) concentrations were higher in large-for-gestational-age compared with appropriate-for-gestational-age fetusesCitation7. Following subgroup analysis in the large-for-gestational-age group, serum cardiotrophin-1 concentrations were higher only in diabetic pregnancies. It was concluded that the determination of several cardiac biomarkers, such as cardiotrophin-1 and titin, in cord blood may have early prognostic value for later development of cardiovascular disease in macrosomic fetuses, particularly those derived from pregnancies with GDMCitation7.
Besides cardiovascular diseases, GDM may also be associated with future offspring neurodevelopmental disordersCitation8. It was demonstrated that fetal serum brain-derived neurotrophic factor concentrations are down-regulated in fetuses exposed to GDM, independently of the fetal growth patternCitation8. This may represent a candidate mechanism underlying the association between maternal GDM and later psychopathology in the offspringCitation8.
Determining markers of GDM among pregnant women, as in the study by Taye et al.Citation1, has important implications both for mothers, as well as for fetuses/neonatesCitation5–8. Future studies should aim to assess cardiovascular risk early in life in order to optimize not only maternal, but also neonatal cardiovascular disease prevention measures in adult life.
Transparency
Declaration of funding
This paper was not funded.
Declaration of financial/other relationships
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
Acknowledgements
None.
References
- Taye H, Kabthymer RH, Hailu S, et al. Previous adverse pregnancy events as a predictor of gestational diabetes mellitus in Southern Ethiopia: a case control study. Curr Med Res Opin. 2022;38(7):1259–1266.
- Poblete JA, Olmos P. Obesity and gestational diabetes in pregnant care and clinical practice. CVP. 2020;19(2):154–164.
- Sobrevia L. Diabetes and obesity in pregnancy: from patients to molecular mechanisms. Curr Vasc Pharmacol. 2021;19(2):111–112.
- Bedell S, Hutson J, de Vrijer B, et al. Effects of maternal obesity and gestational diabetes mellitus on the placenta: current knowledge and targets for therapeutic interventions. Curr Vasc Pharmacol. 2021;19(2):176–192.
- Espinoza C, Fuenzalida B, Leiva A. Increased fetal cardiovascular disease risk: potential synergy between gestational diabetes mellitus and maternal hypercholesterolemia. Curr Vasc Pharmacol. 2021;19(6):601–623.
- Fowden AL, Camm EJ, Sferruzzi-Perri AN. Effects of maternal obesity on placental phenotype. Curr Vasc Pharmacol. 2021;19(2):113–131.
- Briana DD, Germanou K, Boutsikou M, et al. Potential prognostic biomarkers of cardiovascular disease in fetal macrosomia: the impact of gestational diabetes. J Matern Fetal Neonatal Med. 2018;31(7):895–900.
- Briana DD, Papastavrou M, Boutsikou M, et al. Differential expression of cord blood neurotrophins in gestational diabetes: the impact of fetal growth abnormalities. J Matern Fetal Neonatal Med. 2018;31(3):278–283.