Cardiac function in gestational diabetes mellitus: A longitudinal study from fetal life to infancy

Abstract

Objective To determine whether cardiac functional and structural changes in fetuses of mothers with gestational diabetes mellitus (GDM) persist in the offspring beyond the neonatal period. Design Longitudinal study. Setting Fetal Medicine Unit in a UK teaching hospital. Methods 73 women with GDM and 73 women with uncomplicated pregnancy were recruited and fetal cardiac scans were performed at 35-36 weeks' gestation. Repeat echocardiogram was performed in their offspring during infancy. Main outcome measures Fetal and infant cardiac functional and structural changes. Results Fetuses of mothers with GDM, compared with controls, had more globular right ventricles (sphericity index 0.7, interquartile range [IQR] 0.6/0.7 versus 0.6, IQR 0.5/0.6, P < 0.001) and reduced right global longitudinal systolic strain (À16.4, IQR À18.9/À15.3 versus À18.5, IQR À20.6/À16.8, P = 0.001) and left global longitudinal systolic strain (À20.1, IQR À22.5/À16.9 versus À21.3, IQR À23.5/À19.5), P = 0.021). In the GDM group, compared with controls, in infancy there was higher left ventricular E/e' (

Pregnancy Complications Lead to Subclinical Maternal Heart Dysfunction—The Importance and Benefits of Follow-Up Using Speckle Tracking Echocardiography

“…Similar findings, including changes of fetal heart shape and biventricular diastolic disfunction at speckle tracking analysis were shown in two other studies [49,50]. Despite maternal diabetic treatment, neonatal follow-up at 6-7 months of age, showed persistent heart remodeling and impairment in diastolic and systolic ventricular function, with lower left ventricular global longitudinal systolic strain [51]. Similar to neonatal persistent changes, maternal subclinical heart dysfunction persists to at least 6 months alter delivery [33,36,37].…”

Associations of maternal gestational diabetes mellitus with alterations in cardiovascular system in early childhood

“…Maternal GDM is an important factor influencing cardiac development. Studies showed that women with GDM had a higher risk of foetal congenital heart disease and foetal cardiac function and structure alterations 5,36 . However, few studies have documented the effect of GDM on child cardiac structure and function beyond infancy.…”

“…2 Maternal GDM affects intrauterine environment, increasing the risk of macrosomia, 3 congenital heart disease 4 and is associated with foetal ventricular hypertrophy. 5 Also, prenatal exposure to GDM exerts a long-term influence on offspring, leading to obesity and diabetes in childhood, which was named 'metabolic imprinting'. 6 Studies have shown that in utero programing resulting from exposure to GDM could determine cardiovascular diseases in adulthood.…”

“…In China, the GDM prevalence was reported to be 17% in an investigation from 2012−2016 2 . Maternal GDM affects intrauterine environment, increasing the risk of macrosomia, 3 congenital heart disease 4 and is associated with foetal ventricular hypertrophy 5 . Also, prenatal exposure to GDM exerts a long‐term influence on offspring, leading to obesity and diabetes in childhood, which was named ‘metabolic imprinting’ 6…”

Effect of Evidence-Based Diet Nursing on Intestinal Flora and Maternal and Infant Prognosis in Patients with Gestational Diabetes

“…Gestational diabetes can cause polyhydramnios, intrauterine infection, ketoacidosis, macrosomia, abortion, premature delivery, malformation, stillbirth, and other maternal and infant complications, which attracted clinical attention [1][2][3]. Reasonable dietary control and exercise therapy can restore blood glucose to the normal range in most patients, which needs to be combined with glucose-lowering medication if necessary.…”