Funding outcome

Cardiovascular disease (CVD), is the leading cause of death globally. Lifestyle choices and family history are major risk factors; however, exposure to an abnormal environment before birth has been identified as a contributor to increased likelihood of long-term adult CVD. For instance, adults whose mothers had diabetes during their pregnancy have been shown to have an increased risk of CVD as adults. Maternal diabetes is known to impact fetal heart structure and function before birth with development of heart defects, heart muscle thickening and reduced function. Although it has been believed that these abnormalities resolve in infants of diabetic mothers (IDMs) within months of delivery, very little data confirms this. Recently, we (including the applicant) demonstrated that the thickened heart muscle in IDMs actually persists in late infancy. We have also shown the aorta, is stiffer in ID Ms particularly in those with worse control of their blood sugar levels in pregnancy. Increased artery stiffness is observed in adults who develop CVD. To understand whether these changes in the heart and the aorta persist into childhood, in the current study we will bring back the same group of children who are now 4-6 years of age for further heart function and blood pressure assessments. This will include 25-30 IDMs and 25-30 whose mothers were healthy. We will assess through noninvasive techniques heart muscle structure, function and blood vessel function, comparing findings between IDMs and controls. We will correlate our findings with abnormalities in the mothers (pregnancy health factors) and the babies (heart structure and function) before birth as well as family indicators of lifestyle, and nutrition and activity levels. Studies linking maternal health during the pregnancy with longer-term cardiovascular health of exposed infants are key to understanding the evolution of CVD in babies with a suboptimal environment before birth.