Key result
An abnormal maternal early pregnancy metabolic profile was associated with an increased risk of TGA in the offspring, particularly in the subgroup of mothers with a BMI over 30 (OR 1.95).
Why the study?
Higher maternal BMI and abnormal glucose metabolism in early pregnancy associate with offspring congenital heart defects, but the underlying mechanisms remain unknown.
Is maternal first trimester metabolic profile associated with transposition of the great arteries in offspring?
Case-Control (n=300)
Is maternal first trimester metabolic profile associated with transposition of the great arteries in offspring?
Effect estimate: OR 1.18
An abnormal maternal early pregnancy metabolic profile, particularly altered VLDL subtype composition, may be associated with an increased risk of transposition of the great arteries in offspring, especially among obese mothers.
May not alter counseling yet; hypothesis-generating for TGA risk in obese mothers, needing prospective validation.
BACKGROUND: Higher maternal body mass index (BMI) and abnormal glucose metabolism during early pregnancy are associated with congenital heart defects in the offspring, but the exact mechanisms are unknown. METHODS: We evaluated the association between maternal first trimester metabolic profile and transposition of the great arteries (TGA) in the offspring in a matched case-control study with 100 TGA mothers and 200 controls born in Finland during 2004-2014. Cases and controls were matched by birth year, child sex, and maternal age and BMI. Serum samples collected between 10- and 14-weeks of gestation were analyzed for 73 metabolic measures. Conditional logistic regression was used to assess the risk for TGA in the offspring, and a subgroup analysis among mothers with high BMI was conducted. RESULTS: Higher concentrations of four subtypes of extremely large very-low-density lipoprotein (VLDL) particles and one of large VLDL particles were observed in TGA mothers. This finding did not reach statistical significance after multiple testing correction. The pooled odds ratio (OR) of the all metabolic variables was slightly higher in TGA mothers in the subgroup with maternal BMI over 25 (OR 1.25) and significantly higher in the subgroup with maternal BMI over 30 (OR 1.95) compared to the original population (OR 1.18). CONCLUSIONS: Our findings indicate that an abnormal maternal early pregnancy metabolic profile might be associated with TGA in the offspring, especially in obese mothers. A trend indicating altered VLDL subtype composition in TGA pregnancies warrants further research.
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Huida et al. (2022) conducted a case-control in Transposition of the great arteries (TGA) in offspring (n=300). Maternal first trimester metabolic profile vs. Matched controls was evaluated on Risk for TGA in the offspring based on metabolic variables (OR 1.18). An abnormal maternal early pregnancy metabolic profile was associated with an increased risk of TGA in the offspring, particularly in the subgroup of mothers with a BMI over 30 (OR 1.95).
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