Anthropometric Indicators As Early Predictors Of Cardiovascular Disease In Infants Of Diabetic Mothers: A Prospective Cross-Sectional Study

Abstract

Background: Gestational Diabetes Mellitus (GDM) affects approximately 7% of pregnancies and increases the risk of adverse neonatal outcomes and future metabolic disorders in offspring, including cardiovascular disease (CVD)(1,2). The pathophysiological adjustments in insulin resistance and adipose metabolism during GDM may influence fetal growth patterns, potentially affecting CVD risk early in life(3,5,8). This study aims to evaluate anthropometric indicators as predictors of CVD risks in infants born to mothers with GDM, drawing on the principles of the Barker hypothesis regarding early metabolic programming (9,10)

Methods: This prospective cross-sectional study included 101 infants born to diabetic mothers at Saveetha Medical College & Research Centre between September 2020 and September 2022. Using the Ballard system for gestational age assessment, infants were classified as appropriate for gestational age (AGA), small for gestational age (SGA), or large for gestational age (LGA) based on birth weight. Anthropometric measurements taken at birth included weight, length, head circumference, abdominal circumference, and the ponderal index. The study was approved by the Institutional Review Board.

Results: In the study, significant differences in neonatal anthropometric measures were evident across three groups: appropriate for gestational age (AGA), small for gestational age (SGA), and large for gestational age (LGA). The Kruskal-Wallis H test highlighted distinct disparities, particularly notable between AGA and LGA groups in birth weight (χ²(2) = 39.68, p < .001), with the AGA group averaging a median weight of 2.96 kg compared to 3.81 kg for the LGA group. Similarly, birth length and head circumference varied significantly, with SGA infants showing the lowest medians and highest variability. These findings align with the objectives to assess and categorize anthropometric variations and their implications for cardiovascular risks. Maternal HbA1c levels also demonstrated a significant impact, with higher HbA1c levels correlating with adverse neonatal outcomes. In the LGA group, 50% of children had mothers with HbA1c levels greater than 8, compared to only 7.2% of AGA infants. This data is crucial for understanding the predictive relationships between maternal glycemic control and neonatal health outcomes.

Conclusion: The study confirms that variations in key anthropometric measurements are linked to maternal glycemic control and can predict cardiovascular risk factors in neonates. The significant differences in anthropometry among AGA, SGA, and LGA groups highlight the need for targeted prenatal monitoring and interventions to mitigate future cardiovascular risks, emphasizing the importance of managing gestational diabetes effectively to improve health outcomes for both mothers and their children.