Wenyuan Xu, Beverly J Spray, Joshua A Daily, Thomas J Fiedorek, Daniel Sadler, Craig Porter, Megan Pagan, Nafisa K Dajani, Dana S Abulez, Mary K Clarkson, Peter M Mourani, Elijah H Bolin
{"title":"妊娠前糖尿病母亲所生婴儿的母体血红蛋白 A1c 与左心室肥厚。","authors":"Wenyuan Xu, Beverly J Spray, Joshua A Daily, Thomas J Fiedorek, Daniel Sadler, Craig Porter, Megan Pagan, Nafisa K Dajani, Dana S Abulez, Mary K Clarkson, Peter M Mourani, Elijah H Bolin","doi":"10.1080/14767058.2024.2407038","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Maternal hemoglobin A1c (HbA1c) has been suggested to be a predictor of left ventricular hypertrophy (LVH) in the offspring of mothers with pre-gestational diabetes mellitus, although there is little data supporting this contention. We aimed to assess the relationship between maternal HbA1c and postnatal LVH.</p><p><strong>Methods: </strong>We performed a retrospective cohort study of infants born to mothers with pre-gestational diabetes mellitus from 2015 to 2021 at our institution. The primary predictor was maternal HbA1c; neonatal left ventricular mass (LVM) z-score was the primary outcome; LVM z-score was considered as both a continuous variable and a binary variable by dichotomizing at 4 to define LVH. Additionally, we used linear regression to determine the relationship between maternal HbA1c and LVM z-score.</p><p><strong>Results: </strong>There were 116 infants who met inclusion (50% female). Mean maternal HbA1c was generally higher in infants with LVH compared to those without LVH (8.2% with LVH vs. 7.2% without LVH [<i>p</i> = 0.009] in the second trimester, and 7.8% vs. 7.0% [<i>p</i> = 0.025] in the third trimester; no significant difference for first trimester). A greater percentage of infants with LVH were intubated (36% vs. 6%, <i>p</i> < 0.001) and had longer average days of hospitalization (9 vs. 5, <i>p</i> = 0.044). Second and third trimester HbA1c was weakly associated with LVM z-score (R<sup>2</sup> = 0.063, <i>p</i> < 0.001 and R<sup>2</sup> = 0.068, <i>p</i> < 0.001, respectively); first trimester HbA1c was not significantly predictive of LVM z-score.</p><p><strong>Conclusion: </strong>Second and third trimester HbA1c is modestly predictive of LVH in infants born to mothers with pre-gestational diabetes mellitus.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"37 1","pages":"2407038"},"PeriodicalIF":1.7000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Maternal hemoglobin A1c and left ventricular hypertrophy in infants of mothers with pre-gestational diabetes.\",\"authors\":\"Wenyuan Xu, Beverly J Spray, Joshua A Daily, Thomas J Fiedorek, Daniel Sadler, Craig Porter, Megan Pagan, Nafisa K Dajani, Dana S Abulez, Mary K Clarkson, Peter M Mourani, Elijah H Bolin\",\"doi\":\"10.1080/14767058.2024.2407038\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Maternal hemoglobin A1c (HbA1c) has been suggested to be a predictor of left ventricular hypertrophy (LVH) in the offspring of mothers with pre-gestational diabetes mellitus, although there is little data supporting this contention. We aimed to assess the relationship between maternal HbA1c and postnatal LVH.</p><p><strong>Methods: </strong>We performed a retrospective cohort study of infants born to mothers with pre-gestational diabetes mellitus from 2015 to 2021 at our institution. The primary predictor was maternal HbA1c; neonatal left ventricular mass (LVM) z-score was the primary outcome; LVM z-score was considered as both a continuous variable and a binary variable by dichotomizing at 4 to define LVH. Additionally, we used linear regression to determine the relationship between maternal HbA1c and LVM z-score.</p><p><strong>Results: </strong>There were 116 infants who met inclusion (50% female). Mean maternal HbA1c was generally higher in infants with LVH compared to those without LVH (8.2% with LVH vs. 7.2% without LVH [<i>p</i> = 0.009] in the second trimester, and 7.8% vs. 7.0% [<i>p</i> = 0.025] in the third trimester; no significant difference for first trimester). A greater percentage of infants with LVH were intubated (36% vs. 6%, <i>p</i> < 0.001) and had longer average days of hospitalization (9 vs. 5, <i>p</i> = 0.044). Second and third trimester HbA1c was weakly associated with LVM z-score (R<sup>2</sup> = 0.063, <i>p</i> < 0.001 and R<sup>2</sup> = 0.068, <i>p</i> < 0.001, respectively); first trimester HbA1c was not significantly predictive of LVM z-score.</p><p><strong>Conclusion: </strong>Second and third trimester HbA1c is modestly predictive of LVH in infants born to mothers with pre-gestational diabetes mellitus.</p>\",\"PeriodicalId\":50146,\"journal\":{\"name\":\"Journal of Maternal-Fetal & Neonatal Medicine\",\"volume\":\"37 1\",\"pages\":\"2407038\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2024-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Maternal-Fetal & Neonatal Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/14767058.2024.2407038\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/9/25 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Maternal-Fetal & Neonatal Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/14767058.2024.2407038","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/9/25 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
Maternal hemoglobin A1c and left ventricular hypertrophy in infants of mothers with pre-gestational diabetes.
Objective: Maternal hemoglobin A1c (HbA1c) has been suggested to be a predictor of left ventricular hypertrophy (LVH) in the offspring of mothers with pre-gestational diabetes mellitus, although there is little data supporting this contention. We aimed to assess the relationship between maternal HbA1c and postnatal LVH.
Methods: We performed a retrospective cohort study of infants born to mothers with pre-gestational diabetes mellitus from 2015 to 2021 at our institution. The primary predictor was maternal HbA1c; neonatal left ventricular mass (LVM) z-score was the primary outcome; LVM z-score was considered as both a continuous variable and a binary variable by dichotomizing at 4 to define LVH. Additionally, we used linear regression to determine the relationship between maternal HbA1c and LVM z-score.
Results: There were 116 infants who met inclusion (50% female). Mean maternal HbA1c was generally higher in infants with LVH compared to those without LVH (8.2% with LVH vs. 7.2% without LVH [p = 0.009] in the second trimester, and 7.8% vs. 7.0% [p = 0.025] in the third trimester; no significant difference for first trimester). A greater percentage of infants with LVH were intubated (36% vs. 6%, p < 0.001) and had longer average days of hospitalization (9 vs. 5, p = 0.044). Second and third trimester HbA1c was weakly associated with LVM z-score (R2 = 0.063, p < 0.001 and R2 = 0.068, p < 0.001, respectively); first trimester HbA1c was not significantly predictive of LVM z-score.
Conclusion: Second and third trimester HbA1c is modestly predictive of LVH in infants born to mothers with pre-gestational diabetes mellitus.
期刊介绍:
The official journal of The European Association of Perinatal Medicine, The Federation of Asia and Oceania Perinatal Societies and The International Society of Perinatal Obstetricians. The journal publishes a wide range of peer-reviewed research on the obstetric, medical, genetic, mental health and surgical complications of pregnancy and their effects on the mother, fetus and neonate. Research on audit, evaluation and clinical care in maternal-fetal and perinatal medicine is also featured.