High blood sugar in pregnancy tied to elevated BP in offspring: Study

In general, the study showed an increased danger of higher systolic blood pressure (SBP) and diastolic blood pressure (DBP) in offspring born to mothers with general HIP and gestational diabetes. The study's findings, published in Diabetology & Metabolic Syndrome, suggest that prenatal interventions targeted at HIP reduction might be beneficial for controlling BP in offspring.

Hyperglycemia in pregnancy is a hyperglycemia type detected first at any time during pregnancy. It can be divided into diabetes mellitus in pregnancy (DIP), including T2DM (type 2 diabetes mellitus) and T1DM (type 1 diabetes mellitus), and gestational diabetes mellitus (GDM).

The HIP is suggested to be a risk factor for increased blood pressure. However, the empirical evidence was inconsistent. Considering this, Xinyue Zhang, from Zhejiang University in Hangzhou, Zhejiang, China, and colleagues aimed to synthesize current evidence investigating the association between HIP and BP in offspring by conducting a systematic review and meta-analysis.

For this purpose, the researchers searched online databases to identify articles published from inception until February 2021. Each article was independently reviewed for quality. The effects were assessed separately while grouping by the offspring's sex, insulin treatment status, economic level, region, published year, and BP measurement.

The researchers included 23 studies comprising 88695 offspring from the 3385 identified citations.

The study led to the following findings:

• The study revealed that the offspring of women with HIP had an increased systolic blood pressure (SBP; mean difference 1.90) and diastolic blood pressure (DBP; mean difference 0.87 mmHg) compared with those whose mothers had normal blood glucose during pregnancy.
• Subgroup analyses showed that gestational diabetes mellitus appeared to have varied impacts on offspring blood pressure by sex of offspring, published year, region and economic level of family, BP measurement and maternal insulin treatment status.

"Our review suggests that gestational diabetes may lead to elevated DBP and SBP in offspring, providing evidence for fetal cardiovascular risks brought by HIP," the researchers wrote. "Our study also revealed that blood pressure is more severely affected after 2011 or when mothers are insulin-untreated."

"All these factors indicate that changes in epigenetic mechanisms may impact the initiation and progression of metabolic diseases warranting future research," they conclude. "Crucially, we also stress the importance of medical treatment and health promotion adapted to social development."

Reference:

Zhang, X., Wang, Y., Xiao, W. et al. Hyperglycaemia in pregnancy and offspring blood pressure: a systematic review and meta-analysis. Diabetol Metab Syndr 15, 10 (2023). https://doi.org/10.1186/s13098-023-00978-2