Assessing the consequences of gestational diabetes mellitus on offspring's cardiovascular health: MySweetHeart Cohort study protocol, Switzerland

Stefano Di Bernardo, Yvan Mivelaz, Adina Mihaela Epure, Yvan Vial, Umberto Simeoni, Pascal Bovet, Sandrine Estoppey Younes, Arnaud Chiolero, Nicole Sekarski, MySweetHeart Research Group, Stefano Di Bernardo, Yvan Mivelaz, Adina Mihaela Epure, Yvan Vial, Umberto Simeoni, Pascal Bovet, Sandrine Estoppey Younes, Arnaud Chiolero, Nicole Sekarski, MySweetHeart Research Group

Abstract

Introduction: Gestational diabetes mellitus (GDM) is a state of glucose intolerance with onset during pregnancy. GDM carries prenatal and perinatal risks as well as long-term risks for the mother and her child. GDM may be involved in the foetal programming of long-term cardiovascular health. However, evidence is sparse and the effect of GDM on cardiovascular health is unknown. To address these issues, we will conduct MySweetHeart Cohort study. The objectives are to assess the effect of GDM on offspring's cardiovascular health early in life by using surrogate markers of cardiovascular disease and atherosclerosis.

Methods and analysis: This is a cohort study of 100 offspring of women with GDM and 100 offspring of women without GDM. At inclusion, a baseline assessment of the mothers will be conducted through means of self-report questionnaires, a researcher-administrated interview, blood pressure and anthropometric measurements, and a maternal blood sampling. Between the 30th and 34th weeks of gestation, a foetal echography will be performed to assess the foetal cardiac structure and function, the fetomaternal circulation and the hepatic volume. At birth, maternal and neonatal characteristics will be assessed. An echocardiography will be performed to assess cardiac structure and function 2-7 days after birth; carotid intima-media thickness will be also measured to assess vascular structure. MySweetHeart Cohort is linked to MySweetHeart Trial (clinicaltrials.gov/ct2/show/NCT02890693), a randomised controlled trial assessing the effect of a multidimensional interdisciplinary lifestyle and psychosocial intervention to improve the cardiometabolic and mental health of women with GDM and their offspring. A long-term follow-up of children is planned.

Ethics and dissemination: Ethical approval has been obtained through the state Human Research Ethics Committee of the Canton de Vaud (study number 2016-00745). We aim to disseminate the findings through regional, national and international conferences and through peer-reviewed journals.

Trial registration number: ClinicalTrials.gov (clinicaltrials.gov/ct2/show/NCT02872974).

Keywords: cardiovascular disease; carotid intima-media thickness; foetal programming; left ventricular mass index; paediatric.

Conflict of interest statement

Competing interests: None declared.

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Figures

Figure 1
Figure 1
Hypothetical and highly simplified causal relationships between gestational diabetes mellitus (GDM) and cardiometabolic disorders. Two pathways can be hypothesised: (1) a direct effect of GDM on offspring’s cardiometabolic disorders; (2) an indirect effect through the mediator large for gestational age (LGA). It means that if LGA was prevented, part of the effect of GDM on cardiometabolic disorders would be prevented. Several confounding factors (such as maternal obesity, weight gain during pregnancy, smoking, socioeconomic status or family history of cardiometabolic diseases) have to be accounted.

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