Funding outcome

Cardiovascular disease (CVD) is a leading cause of death throughout the world with many established risk factors including hypercholesterolemia, lifestyle choices (e.g. inactivity, smoking) and family history. It has more recently been discovered that some risk factors or precursors to CVD develop before birth due to exposure of the baby to an abnormal enviroment while still in the womb. Adults whose mothers had diabetes while pregnant, for instance, have been shown to be at increased risk for developing CVD long-term. There is a paucity of research, however, exploring contributing factors in the pregnancy and longitudinal cardiovascular health of the infant and child following this exposure. In the current research Victor will be exploring how pregestational and gestational diabetes affect the heart and blood vessel structure and function of infants and children born to these mothers, and whether these changes resolve in early infancy or persist into early childhood, potentially contributing to CVD disease in adulthood. This research is part of a longitudinal study investigating how maternal diabetes impacts fetal and postnatal cardiovascular health of the baby and ultimately contributes to adult CVD. Victor will learn state-of-the-art echocardiographic (ultrasound of the heart) techniques to assess ventricular wall thickness and function and blood vessel structure and function. From previously performed echocardiograms in 50 infants of diabetic mothers (IDM) and 40 age-matched controls in early (4-6 weeks) and late (6-12 months) infancy, he will measure parameters of cardiovascular health. He will also participate in repeat assessments of the children at 3-6 years which is to take place this summer with the support of a senior clinical research fellow within the Stollery Cardiology Program. He will compare ventricular wall thickness and function, aortic stiffness and vascular function between IDM and controls at all stages (early and late infancy and early childhood) to determine if there are differences, and will correlate findings in IDMs with a standard measure of sugar control in the mothers (hemoglobin Ale) during pregnancy, with maternal health in pregnancy, infant birth weight and placental pathology from the pregnancies. This work will provide insight into the timing of evolution of cardiovascular changes associated with maternal DM and how sugar control and placental changes may contribute. Ultimately, if the at risk pregnancies can be identified and the mothers and/or their infants are treated, long-term CVD may be prevented in this population.