Key result
Maternal type 1 diabetes was associated with a significantly increased risk of isolated congenital heart defects in offspring (OR 3.71), whereas maternal overweight and obesity were not.
Why the study?
Congenital heart defects affect 1-2% of newborns and are linked to significant morbidity and mortality, making the identification of underlying risk factors essential for prevention.
Are maternal diabetes and overweight/obesity associated with an increased risk of congenital heart defects in offspring?
Cohort (n=620,751)
Are maternal diabetes and overweight/obesity associated with an increased risk of congenital heart defects in offspring?
Maternal type 1 diabetes is a strong risk factor for congenital heart defects in offspring, whereas maternal overweight and obesity have a less profound association than previously reported.
May guide preconception counseling for type 1 diabetes; confirms association while leaving obesity role open.
Importance Congenital heart defects (CHDs) affect 1–2% of newborns and are associated with significant mortality and morbidity. Understanding risk factors underlying CHDs is essential for prevention. Objective To determine the association between maternal diabetes and overweight/obesity and CHDs among offspring. Design Nationwide population-based register study. Setting Finland Participants All children born between 2006–2016 (N=620 751), and their mothers. Exposures Maternal pre-pregnancy body mass index (BMI) categorized as underweight (<18.5 kg/m 2 ), normal (18.5–24.9 kg/m 2 ), overweight (25.0–29.9 kg/m 2 ), and obese (≥30 kg/m 2 ). Maternal diabetes classified as no diabetes, type 1 (T1DM), type 2/other (T2DM), and gestational diabetes (GDM). Main Outcomes and Measures Odds ratio (OR) of isolated CHD in the child. In addition, nine anatomical CHD subgroups were studied. Results Of the 620 751 children born in Finland during the study period, 10 254 (1.65%) had an isolated CHD. T1DM was associated with an increased risk of having a child with any CHD (OR 3.71 (95% CI 3.16–4.35)), whereas maternal overweight (OR 0.98 (95% CI 0.98–1.04)) and obesity (OR 1.00 (95% CI 0.93–1.07)) were not. When analyzing anatomical subgroups, T1DM was associated with an increased risk in six subgroups. Maternal overweight was associated with complex defects (OR 2.24 (95% CI 1.01–4.94)), left ventricular outflow tract obstruction (OR 1.26, (95% CI 1.07–1.49), maternal obesity with complex defects (OR 3.22 (95% CI 1.31–7.92)), and right ventricular outflow tract obstruction (OR 1.26, (95% CI 1.01–1.55)). At the population level, maternal diabetes was responsible for 3.0% and maternal overweight and obesity for 0.7% of offspring’s CHD. Conclusions and Relevance This study indicated a less profound association between maternal overweight and obesity and CHD in the offspring than previously reported. The different risk profiles of T1DM and overweight/obesity may suggest distinct underlying teratogenic mechanisms.
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Turunen et al. (2023) conducted a cohort in Congenital heart defects (n=620,751). Maternal diabetes and overweight/obesity vs. No diabetes and normal body mass index was evaluated on Isolated congenital heart defect (CHD) in the child (OR 3.71, 95% CI 3.16-4.35). Maternal type 1 diabetes was associated with a significantly increased risk of isolated congenital heart defects in offspring (OR 3.71), whereas maternal overweight and obesity were not.
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