Investigating the causal impact of gestational diabetes on youth-onset hypertension in offspring

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dc.contributor.authorBrunton, Nicole
dc.contributor.examiningcommitteeNickel, Nathan (Kinesology & Recreation Management)
dc.contributor.examiningcommitteeDart, Allison (Kinesology & Recreation Management)
dc.contributor.examiningcommitteeDasgupta, Kaberi (McGill University)
dc.contributor.supervisorMcGavock, Jonathan
dc.contributor.supervisorDuhamel, Todd
dc.date.accessioned2024-12-03T13:52:49Z
dc.date.available2024-12-03T13:52:49Z
dc.date.issued2024-11-28
dc.date.submitted2024-11-28T20:20:59Zen_US
dc.date.submitted2024-12-02T19:50:38Zen_US
dc.date.submitted2024-12-02T22:37:02Zen_US
dc.degree.disciplineApplied Health Sciences
dc.degree.levelDoctor of Philosophy (Ph.D.)
dc.description.abstractHypertension is the second most common pediatric chronic disease worldwide. Previous work suggests that an individual’s risk for hypertension could begin in utero. Early seminal studies demonstrated a link between exposure to malnutrition in utero and elevated risk for cardiometabolic abnormalities in the offspring. In the 21st century, studies revealed that hyperglycemia, pre-pregnancy diabetes, and gestational diabetes were all associated with markers of offspring cardiovascular health including increased blood pressure. However, it was not clear whether these associations represented a causal effect. Additionally, it is unclear the extent to which trends in gestational diabetes incidence have changed over time. This thesis was designed to fill these knowledge gaps. First, I conducted a descriptive study of gestational diabetes incidence to assess trends over time and among high-risk groups. Second, to investigate the causal impact of gestational diabetes on youth-onset hypertension among offspring, I conducted a triangulation study. Triangulation in epidemiology refers to conducting multiple studies, all designed to assess the same research question, that have differing limitations, risk of bias, and assumptions. For this thesis I conducted (1) an exact-matched study, (2) a negative exposure control study, and (3) a discordant sibling-matched study. Results showed that diagnosis of gestational diabetes has increased markedly over the last several decades with high-risk groups experiencing the highest rates and lower risk groups experiencing the highest increase in rates. Additionally, the evidence suggests that it is unlikely that exposure to gestational diabetes confers a direct independent increased risk for the development of youth-onset hypertension. Collectively, the work completed for this thesis demonstrates the importance of exploring causal factors that may simultaneously contribute to the cause of both elevated gestational diabetes and elevated youth-onset hypertension.
dc.description.noteFebruary 2025
dc.identifier.urihttp://hdl.handle.net/1993/38692
dc.language.isoeng
dc.rightsopen accessen_US
dc.subjectTriangulation
dc.subjectGestational diabetes
dc.subjectPediatric hypertension
dc.subjectLife course epidemiology
dc.titleInvestigating the causal impact of gestational diabetes on youth-onset hypertension in offspring
dc.typedoctoral thesisen_US
local.subject.manitobayes
oaire.awardTitle2022 Research Manitoba-Children's Hospital Research Institute of Manitoba PhD in Health Research Studentship Award
oaire.awardURIhttps://researchmanitoba.ca/funding/programs/phd-research-studentship/
project.funder.nameResearch Manitoba
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